Patient positioning support apparatus with virtual pivot-shift pelvic pads, upper body stabilization and fail-safe table attachment mechanism

ABSTRACT

A patient support apparatus for supporting a patient in a prone position during a surgical procedure is provided, including an open fixed frame suspended above a floor and a pair of spaced opposed radially sliding joints cooperating with the frame, each joint including a virtual pivot point and an arc of motion spaced from the virtual pivot point, the joints being movable along the arc providing a pivot ship mechanism for a pair of pelvic pads attached to the joints. A base for supporting and suspending a patient support structure above the floor, for supporting a patient during a surgical procedure, the base including a pair of spaced opposed vertical translation subassemblies reversibly attachable to a patient support structure, a cross-bar, and a rotation subassembly having two degrees of rotational freedom; wherein a location of each vertical translation subassembly is substantially constant during operation of the patient support structure.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a divisional application of U.S. patentapplication Ser. No. 15/421,994, filed Feb. 1, 2017, which is acontinuation application of U.S. patent application Ser. No. 14/012,434,entitled “PATIENT POSITIONING SUPPORT APPARATUS WITH VIRTUAL PIVOT-SHIFTPELVIC PADS, UPPER BODY STABILIZATION AND FAIL-SAFE TABLE ATTACHMENTMECHANISM”, filed Aug. 28, 2013, now U.S. Pat. No. 9,642,760. Theentireties of these applications is incorporated by reference herein.

Application Ser. No. 14/012,434 is a continuation-in-part application ofU.S. patent application Ser. No. 13/956,704, entitled “PATIENT SUPPORTAPPARATUS WITH BODY SLIDE POSITION DIGITALLY COORDINATED WITH HINGEANGLE”, filed Aug. 1, 2013, the entirety of which is incorporated byreference herein. Application Ser. No. 13/956,704 claimed the benefit ofU.S. Provisional Patent Application Nos.: 61/742,098, filed Aug. 2,2012; 61/852,199, filed Mar. 15, 2013; 61/849,016, filed Jan. 17, 2013;61/849,035, filed Jan. 17, 2013; 61/795,649, filed Oct. 22, 2012; and61/743,240, filed Aug. 29, 2012. The entirety of all Patent Applicationsare incorporated by reference herein in their entireties.

Application Ser. No. 14/012,434 is also a continuation-in-partapplication of U.S. patent application Ser. No. 13/694,392, entitled“PATIENT POSITIONING SUPPORT STRUCTURE WITH COORDINATED CONTINUOUSNONSEGMENTED ARTICULATION, ROTATION AND LIFT, AND LOCKING FAIL-SAFEDEVICE”, filed Nov. 28, 2012, which claimed the benefit of U.S.Provisional Patent Application No. 61/629,815, filed Nov. 28, 2011, theentirety of which are incorporated herein by reference.

TECHNICAL FIELD

The present disclosure relates to patient positioning supportstructures.

BACKGROUND OF THE INVENTION

The present invention is direct to structures for supporting a patientin a desired position during examination and treatment, includingmedical procedures such as imaging and surgery and in particular to sucha structure that allows a surgeon to selectively position the patientfor convenient access to the surgery site and providing for manipulationof the patient during surgery including the tilting, pivoting,angulating or bending of a trunk and additionally or alternatively jointof a patient in a supine, prone or lateral-decubitus position, whilesimultaneously maintaining the patient's head in a convenient locationfor anesthesia and substantially preventing undesired stretching orcompression of the patient's spine and the patient's skin.

Current surgical procedures and approaches incorporate imagingtechniques and technologies that facilitate the surgical plan andimprove outcomes and that provide for more rapid patient recovery. Forexample, minimally invasive surgical techniques, such as percutaneousinsertion of spinal implants, involve small incisions that are guided bycontinuous or repeated intra-operative imaging and that are frequentlyassociated with navigation technologies. These imaging and navigationtechniques can be processed using computer software programs thatproduce two or three dimensional images for reference by the surgeonduring the course of the procedure. If the patient support structure,apparatus, system or device is not radiolucent or configured to becompatible with the imaging technologies, it may be necessary tointerrupt the surgery periodically in order to remove the patient to aseparate structure for imaging followed by transfer back to theoperating support structure for resumption of the surgical procedure.Such patient transfers for imaging purposes may be avoided by employingradiolucent and other imaging and navigation compatible systems. Thepatient support system should also be constructed to permit unobstructedmovement of the imaging equipment and other surgical equipment around,over and under the patient throughout the course of the surgicalprocedure without contamination of the sterile field.

It is also necessary that the patient support structure be constructedto provide optimum access to the surgical field by the surgery team.Some procedures require positioning of portions of the patient's body indifferent ways at different times during the procedure. Some procedures,for example, spinal surgery, involve access through more than onesurgical site or field. Since all of these fields may not be in the sameplane or anatomical location, the patient support surfaces should beadjustable and capable of providing support in different planes fordifferent parts of the patient's body as well as different positions oralignments for a given part of the body. Preferably, the patient supportshould be adjustable to provide support in separate planes and indifferent alignments for the head and upper trunk portion of thepatient's body, the lower trunk and pelvic portion of the body as wellas each of the limbs independently.

Certain types of surgery, such as orthopedic surgery, may require thatthe patient or a part of the patient be repositioned during theprocedure while in some cases maintaining the sterile field. Wheresurgery is directed toward motion preservation procedures, such as byinstallation of artificial joints, soft or dynamic stabilizationimplants, spinal ligaments and total disc prostheses, for example, thesurgeon must be able to manipulate certain joints while supportingselected portions of the patient's body during surgery in order tofacilitate the procedure. It is also desirable to be able to test therange of motion of the surgically repaired or stabilized joint and toobserve the gliding movement of the reconstructed articulatingprosthetic surfaces or the tension and flexibility of artificialligaments, cords, spacers and other types of dynamic stabilizers beforethe wound is closed. Such manipulation can be used, for example, toverify the correct positioning and function of an implanted prostheticdisc, spinal dynamic longitudinal connecting member, interspinous spaceror joint replacement during a surgical procedure. Where manipulationdiscloses binding, sub-optimal position or even crushing of the adjacentvertebrae, for example, as may occur with osteoporosis, the prosthesiscan be removed and the adjacent vertebrae fused or otherwise treatedwhile the patient remains anesthetized. Injury which might otherwisehave resulted from a “trial” use of the implant post-operatively will beavoided, along with the need for a second round of anesthesia andsurgery to remove the implant or prosthesis and perform the revision,fusion or corrective surgery.

There is also a need for a patient support structure that can berotated, articulated and angulated so that the patient can be moved orrolled from a supine position to a prone position, or from alateral-decubitus to a supine position, or from a prone position to aposition with the hips and knees flexed or extended, and wherebyintra-operative extension and flexion of at least a portion of thespinal column can be achieved to change lumbar lordosis. The patientsupport structure must also be capable of cooperating with thebiomechanics of the patient for easy, selective adjustment withoutnecessitating removal of the patient or causing substantial interruptionof the procedure.

For certain types of surgical procedures, for example spinal surgeries,it may be desirable to position the patient for sequential anterior,posterior and additionally or alternatively lateral procedures. Thepatient support structure should also be capable of rotation about anaxis in order to provide correct positioning of the patient and optimumaccessibility for the surgeon as well as imaging equipment during suchsequential procedures, and also without translating the patient's head,which could disrupt connection of the patient with anesthesia equipment,and also without undesirably distracting or compressing the patient'sspine during angulation or rotation of the patient's pelvis around thehips.

Orthopedic procedures involving fractures and other trauma may requirethe use of traction equipment such as cables, tongs, pulleys andweights. The patient support system must include structure andaccessories for anchoring such equipment and it must provide adequatesupport to withstand unequal forces generated by traction against suchequipment.

Orthopedic procedures, especially spine surgery, may also require theuse of an open frame, instead of a closed table top, that allows a pronepatient's belly to hang downwardly therebetween so as to preventcompression of internal organs against the anterior side of thepatient's spine and prevent compression of the patient's vessels todecrease blood loss.

Articulated robotic arms are increasingly employed to perform surgicaltechniques. These units are generally designed to move short distancesand to perform very precise work. Reliance on the patient supportstructure to perform any necessary gross movement of the patient can bebeneficial, especially if the movements are synchronized or coordinated.Such units require a surgical support surface capable of smoothlyperforming the multi-directional movements which would otherwise beperformed by trained medical personnel. There is thus a need in thisapplication as well for integration between the robotics technology andthe patient positioning technology.

While conventional operating tables generally include structure thatpermits tilting or rotation of a patient support surface about alongitudinal axis, previous surgical support devices have attempted toaddress the need for access by providing a cantilevered patient supportsurface on one end. Such designs typically employ either a massive baseto counterbalance the extended support member or a large overhead framestructure to provide support from above. The enlarged base membersassociated with such cantilever designs are problematic in that they canand do obstruct the movement of C-arm and O-arm mobile fluoroscopicimaging devices and other equipment. Surgical tables with overhead framestructures are bulky and may require the use of dedicated operatingrooms, since in some cases they cannot be moved easily out of the way.Neither of these designs is easily portable or storable. More recentorthopedic surgical tables require complicated mechanisms to providetranslation of the patient's trunk while manipulating the patient'slower body during surgery.

More recent and advanced articulating surgical tables are available, andinclude an open frame patient support for positioning with upper andlower body support portions joined by centrally located and spaced aparthinges. However, while these surgical tables enable bending the patientat the waist or hips, maintaining the vertical height of the surgicalsite can be difficult. These tables can also cause significanttranslation of the patient's trunk toward and away from anesthesia,which is undesirable. These tables also require complex translationcompensation structural mechanisms to prevent potential patient injury.

Thus, there remains a need for a patient support structure that provideseasy access for personnel and equipment, that can be easily and quicklypositioned and repositioned in multiple planes without the use ofmassive counterbalancing support structure, that can maintain thepatient's head at a convenient location for anesthesia duringpositioning of the patient, that does not cause undesired stretching orcompression of the patient's spine and skin and that does not requireuse of a dedicated operating room.

SUMMARY OF THE INVENTION

The present invention is directed to a patient support structure thatpermits adjustable positioning, repositioning and selectively lockablesupport of a patient's head and upper body, lower body and limbs in upto a plurality of individual planes while permitting tilting, rotation,flexion, extension, angulation, articulation and bending, and othermanipulations as well as full and free access to the patient by medicalpersonnel and equipment. The apparatus of the present invention may becantilevered or non-cantilevered, such as in the case of a dual-columnbase, and includes at least a prone patient support structure that issuspended above a floor, that is adapted to cooperate with the patient'sbiomechanics so as to allow positioning of the patient's hips and kneesin a neutral position, a flexed position and an extended position. Theapparatus allows positioning of the patient parallel with the floor orin Trendelenburg or reverse Trendelenburg surgical positions, andoptionally while also tilting or rolling the patient with respect to thefloor, along a horizontal axis, and while simultaneously maintaining thepatient's head in a suitable location for anesthesia, withoutsubstantial horizontal translation, and also while preventing undesiredspinal distraction or compression. The patient support structure of thepresent invention includes an open frame that allows the patient's bellyto fall, extend, depend or hang downwardly therethrough between a pairof spaced opposed and somewhat centrally located radially sliding orgliding joints that enable flexion and extension of the prone patient'ships and knees with respect to a virtual pivot point located on or abovepatient pelvic support pads. The pelvic pads are sized, shaped andconfigured to follow an arc of motion associated with the joint anddefined by a radius. The joint joins the pelvic pads with a lower bodyor lower extremity support structure or frame. The prone patient supportstructure includes one or more hip-thigh or pelvic pads attached to oneor both of the joints and an adjustable torso support with a chest padslidingly attached to a fixed rigid outer frame. The torso support,chest pad and hip-thigh pads are substantially radiolucent, so as to notinterfere with imaging when the patient is on the patient positioningsupport system 5.

The apparatus of the present invention may also include a supine patientsupport structure comprised of two sections and suspended above thefloor. The sections are connected at a pair of spaced opposed hingesthat angulate and translate. The supine patient support structure issize, shaped and configured for positioning the patient in an angulatedor articulated and non-articulated prone, supine or lateral position andfor performing a sandwich-and-roll procedure, wherein the patient isrolled over 180-degrees between supine and prone positions.

The surgical table of the present invention may also include a base thatis sized, shaped and configured to hold the prone and supine patientsupports above the floor and also to provide for vertical translation orheight adjustment of one or both of the patient support structures aswell as three degrees of freedom with respect to movement of the patientsupport structure relative to a roll axis, a pitch axis and a yaw axis.

The surgical table of the present invention may also include a fail-safeconnection mechanism for connecting a patient support structure to thebase while simultaneously preventing incorrect disconnection of apatient support structure from the base, which could cause the supportstructure to collapse and result in patient injury. The patient supportstructure can also provide for a length adjustment with respect to thebase when the structure is angulated or the ends are pivoted so as toput the structure into a Trendelenburg or reverse Trendelenburgposition.

In an embodiment of the present invention, a patient support apparatusfor supporting a patient in a prone position during a surgical procedureis provided, wherein the apparatus includes an open fixed frame that issuspended above a floor, and a pair of spaced opposed radially slidingjoints that cooperate with the frame, wherein each joint includes avirtual pivot point and an arc of motion spaced from the virtual pivotpoint, and the joints are movable along the arc so as to provide a pivotshift mechanism for a pair of pelvic pads attached to the joints.

In a further embodiment, the joints are movable between a first positionand a second position with respect to the virtual pivot point, the arcof motion and the floor.

In a further embodiment, the virtual pivot point is located within apatient supported on the apparatus.

In a further embodiment, the virtual pivot point is located at a contactpoint between a patient supported on the apparatus and a hip-thigh pad.

In some embodiments, the hip-thigh pad is joined with a joint.

In some embodiments, the virtual pivot point is located adjacent to aspine of a patient supported on the apparatus.

In a further embodiment, the virtual pivot point includes a height abovethe floor; wherein the height is substantially constant during movementof the joint with respect to the virtual pivot point.

In a further embodiment, the height is adjustable.

In a further embodiment, the virtual pivot point is associated with afirst pitch axis, such as an axis of articulation or angulation.

In a further embodiment, each joint includes a radius that extends fromthe virtual pivot point in a plane substantially perpendicular to thefirst pitch axis, such that the radius defines at least a portion of thearc of motion.

In a further embodiment, the apparatus further includes a hip-thigh padjoined with one of the joints so as to be movable about the virtualpivot point and with respect to the arc of motion.

In a further embodiment, at least a portion of the hip-thigh pad glidesalong the arc of motion.

In a further embodiment, the apparatus further includes a lowerextremity support structure joined with the joints such that the lowerextremity support structure is movable with respect to the virtual pivotpoint and between a first position and a second position.

In a further embodiment, the apparatus further includes a chest padattachable to a head-end portion of the frame.

In a further embodiment, the apparatus further includes a hip-thigh padassociated with a lower-body side of the joint; wherein the chest pad isassociated with an upper-body side of the joint, so as to be opposed toand spaced a distance from the hip-thigh pad.

In a further embodiment, the distance between the chest pad and thehip-thigh pad is substantially constant during movement of the jointbetween a first position and a second position.

In a further embodiment, the distance between the chest pad and thehip-thigh pad is slightly variable during movement of the joint.

In a further embodiment, the hip-thigh pad translates laterally duringmovement of the joint, such as but not limited toward or away from thehead-end of the base when moving between neutral and angulatedpositions.

In a further embodiment, the apparatus further includes a lowerextremity support structure joined with the joints such that the lowerextremity support structure is movable with respect to the virtual pivotpoint.

In a further embodiment, the lower extremity support structure includesa femoral support and a lower leg cradle.

In a further embodiment, the femoral support includes an adjustablesling.

In a further embodiment, the femoral support and the lower leg cradleare pivotably connected so as to be movable between a first position anda second position; and wherein when in the first position, the femoralsupport and the lower leg cradle are in a neutral position; and when inthe second position, the femoral support and the lower leg cradle are ina flexed position.

In a further embodiment, the lower leg cradle is non-incrementallyadjustable with respect to the femoral support and between the neutralposition and a maximally flexed position.

In a further embodiment, the lower leg cradle is continuously adjustablewith respect to the femoral support and between the neutral position anda maximally flexed position.

In a further embodiment, the lower leg cradle is incrementallyadjustable with respect to the femoral support.

In a further embodiment, the femoral support and the lower leg cradleare joined by a pair of spaced opposed lower leg hinges.

In a further embodiment, the chest pad is slidably adjustable withrespect to a length of the frame.

In a further embodiment, the chest pad is attachable to the frame.

In a further embodiment, the chest pad is lockable.

In a further embodiment, the chest pad is located adjacent to thejoints.

In a further embodiment, the chest pad includes at least two chest pads.

In a further embodiment, the frame includes head-end portion; and thechest pad is adjustable along a length of the frame head-end portion andbetween a first location adjacent to an outer-end of the frame head-endportion and a second location adjacent to the joints.

In a further embodiment, the chest pad is substantially radiolucent.

In a further embodiment, the hip-thigh pad includes a pair of hip-thighpads spaced apart with respect to the frame so as to provide a space forat least a portion of a patient's body to be positioned therebetween.

In a further embodiment, the hip-thigh pad is substantially radiolucent.

In a further embodiment, the apparatus further includes a base.

In a further embodiment, the base includes a pair of laterally spacedvertical translator subassemblies, each vertical translator subassemblyincluding an upper end portion and a lower end portion; and a crossbarjoining the lower end portions of the vertical translator subassembliessuch that the vertical translator subassemblies are spaced apart aconstant distance; wherein the frame is suspended from upper endportions of the vertical translator subassemblies.

In a further embodiment, the base includes a pair of connectionsubassemblies, each of connection subassemblies including: a ladderattachment structure or connector portion; and a ladder or attachmentupright attached to the ladder attachment structure.

In a further embodiment, the ladder is removably attached to the ladderattachment structure.

In a further embodiment, the ladder is lockably attached to the ladderattachment structure.

In a further embodiment, the ladder includes a set of ladders, the setof ladders including a pair of standard length ladders.

In a further embodiment, the ladder includes at least one additionalladder selected from the group consisting of standard length ladders andextended-length ladders.

In a further embodiment, the apparatus further includes a T-pinassociated with at least one of a second pitch axis and a third pitchaxis; wherein the T-pin joins an outer end of the frame with the base.

In a further embodiment, the frame is pivotable about the T-pin withrespect to a joined vertical translator subassembly in response tovertical movement of the joined vertical translator subassembly.

In a further embodiment, the frame is positionable in a Trendelenburgposition and a Reverse Trendelenburg position.

In a further embodiment, at least one of the vertical translatorsubassembly upper end portions includes a rotation subassembly.

In a further embodiment, at least a portion of the frame iscantilevered.

In a further embodiment, the frame foot-end portion includes: atranslation compensation subassembly.

In a further embodiment, the frame includes: a longitudinally extendingroll axis.

In a further embodiment, the frame is rotatable about the roll axis anamount of between about 1-degree and about 237-degrees.

In a further embodiment, the frame is continuously adjustable withrespect to the roll axis and between a non-rolled orientation and anorientation associated with rolling an amount of about 237-degrees aboutthe roll axis.

In a further embodiment, the frame is adapted to rotate with respect tothe roll axis so as to be rolled an amount of about 180-degrees, so asto be positioned in an inverted orientation or position.

In a further embodiment, the frame is non-incrementally rotatable,pivotable or rollable about or around the roll axis.

In a further embodiment, the frame is lockable in a rolled position.

In a further embodiment, the apparatus further includes a supine patientsupport structure suspended above the floor.

In a further embodiment, the supine patient support structure includesan open frame that is articulatable at a pair of spaced opposed hinges;and at least one of a set of body support pads and a closed table-top.

In a further embodiment, the body support pads, the elongate table padand the table-top are substantially radiolucent.

In a further embodiment, the supine patient support structure ispositionable in a decubitus position.

In a further embodiment, the supine patient support structure is spacedfrom and opposed to the frame.

In a further embodiment, at least one of the vertical translationsubassemblies includes a rotation subassembly adapted to roll the frameabout a longitudinally extending roll axis.

In a further embodiment, the hip-thigh pad includes a hip-thigh padmount joining the hip-thigh pad with one of the joints.

In a further embodiment, the apparatus includes a fail-safe mechanism.

In another embodiment, a method of positioning a patient on a patientsupport in a prone position is provided, the method comprising the stepsof placing a patient on a supine patient support suspended above afloor, such that the patient is in a substantially supine position;sandwiching the patient between the supine patient support and a pronepatient support suspended above the supine patient support; and rollingthe patient an amount of about 180-degrees with respect to alongitudinally extending roll axis, such that the patient is in asubstantially prone position.

In a further embodiment, the method includes removing the supine patientsupport.

In a further embodiment, the step of sandwiching the patient between thesupine patient support and a prone patient support includes attachingthe prone patient support to a pair of spaced opposed ladder attachmentstructures.

Therefore, the patient positioning support structure of the presentinvention is configured and arranged to overcome one or more of theproblems with patient support systems described above. In someembodiments, the present invention provides a prone patient supportstructure that avoids a pair of spaced opposed hinges that translate andangulate, while cooperating with the patient's biomechanics to positionthe patient in and to move the patient's spine between neutral, flexedand extended positions while substantially preventing vertical andhorizontal translation of the patient's torso. In some embodiments, thepresent invention provides such structures that allow for simultaneousrolling or tilting of the patient. In some embodiments, the presentinvention provides such structure wherein the base support is located atan end of the patient support structure, so as to allow for patientpositioning and clearance for access to the patient in a wide variety oforientations. In some embodiments, the present invention provides suchstructure that may be rotated about an axis as well as moved upwardly ordownwardly at either end thereof. In some embodiments, the presentinvention provides a fail-safe structure that prevents patient injurydue to certain operator errors. In some embodiments, the presentinvention provides such apparatus and methods that are easy to use andespecially adapted for the intended use thereof and wherein theapparatus are comparatively inexpensive to make and suitable for use.

In yet another embodiment, present invention is directed to a base forsupporting and suspending a patient support structure above the floor,such as for supporting a patient during a surgical procedure. The baseincludes a pair of spaced opposed vertical translation subassembliesreversibly attachable to a patient support structure, a cross-bar, and arotation subassembly that includes two degrees of rotational freedom.The location of each vertical translation subassembly is substantiallyconstant during operation of the patient support structure, such thatthe vertical translation subassemblies do not move closer or fartherapart during table operation.

Each of the vertical translation subassemblies includes a base portionand an off-set elevator subassembly that extends upwardly from the baseportion. The vertical translation subassemblies each include anelevator, such as a primary elevator and a rotation subassembly.

In a further embodiment, the base includes a longitudinally extendingroll axis and a pitch axis that extends perpendicularly to the roll axisand is also parallel to the floor.

In a further embodiment, each of the rotation subassemblies includesfirst and second rotation motor subassemblies. The first rotation motorsubassembly includes a first shaft that extends parallel to thecross-bar and is adapted for releasable attachment of the patientsupport structure thereto. The second rotation motor subassemblyincludes a second shaft that joins the first rotation motor subassemblywith an elevator of a respective vertical translation subassembly, suchthat the second rotation motor subassembly can rotate the first rotationmotor subassembly with respect to a pitch axis that extendsperpendicular to a roll axis and is also parallel with the floor.

The drawings constitute a part of this specification and includeexemplary embodiments of the present invention and illustrate variousobjects and features thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a patient positioning support system ofthe present invention in one embodiment, including a base and a pronepatient support structure.

FIG. 2 is a perspective view of a base of the patient positioningsupport system of FIG. 1, including a pair of laterally spaced opposedvertical translator subassemblies.

FIG. 3 is a perspective view of a prone patient support structure of thepatient positioning support system of FIG. 1.

FIG. 4 is reduced right side view of the patient positioning supportsystem of FIG. 1.

FIG. 5 is a top view of the patient positioning support system of FIG.4.

FIG. 6 is a bottom view of the patient positioning support system ofFIG. 4.

FIG. 7 is a head-end view of the patient positioning support system ofFIG. 4.

FIG. 8 is a foot-end view of the patient positioning support system ofFIG. 4.

FIG. 9 is reduced left side view of the patient positioning supportsystem of FIG. 1.

FIG. 10 is an enlarged perspective view of a ladder of the patientpositioning support system of FIG. 1.

FIG. 11 is an enlarged perspective view of a T-pin of the patientpositioning support system of FIG. 1.

FIG. 11A is an enlarged cross-sectional view of a portion of the T-pinto show greater detail of positioning of the locking portion thereof,the cross-section being taken along line 11A-11A of FIG. 11.

FIG. 12 is an enlarged perspective view of a torso support subassemblyof the patient positioning support system of FIG. 1.

FIG. 13 is an enlarged perspective view of a connection subassembly ofthe patient positioning support system of FIG. 1, with portions brokenaway.

FIG. 14 is an enlarged cross-section of the patient positioning supportsystem of FIG. 1, the cross-section being taken along the line 14-14 ofFIG. 5, with portions broken away.

FIG. 15 is an enlarged perspective view of a ladder connectionsubassembly of the patient positioning support system of FIG. 1.

FIG. 16 is a front view of the ladder connection subassembly of FIG. 15.

FIG. 17 is a first side view of the ladder connection subassembly ofFIG. 15.

FIG. 18 is a second side view of the ladder connection subassembly ofFIG. 15.

FIG. 19 is a top view of the ladder connection subassembly of FIG. 15.

FIG. 20 is a bottom view of the ladder connection subassembly of FIG.15.

FIG. 21 is a reduced back perspective view of the ladder connectionsubassembly of FIG. 15, with a pair of ladders attached thereto and aportion of the rotation subassembly extending therefrom.

FIG. 22 is a back view of the ladder connection subassembly of FIG. 15.

FIG. 23 is a reduced perspective view of the patient positioning supportsystem of FIG. 1, with the patient support structure in a reverseTrendelenburg position.

FIG. 24 is a right side view of the patient positioning support systemof FIG. 23.

FIG. 25 is a head-end view of the patient positioning support system ofFIG. 23.

FIG. 26 is a foot-end view of the patient positioning support system ofFIG. 23.

FIG. 27 is a top view of the patient positioning support system of FIG.23.

FIG. 28 is a right side view of the patient positioning support systemof FIG. 23, wherein the patient support structure has been rolled25-degrees toward the left side of the table.

FIG. 29 is an enlarged view of the head-end of the patient positioningsupport system of FIG. 24, with portions broken away.

FIG. 30 is an enlarged view of the foot-end of the patient positioningsupport system of FIG. 24, with portions broken away.

FIG. 31 is a reduced perspective view of the patient positioning supportsystem of FIG. 1, with the patient support structure in a Trendelenburgposition.

FIG. 32 is a right side view of the patient positioning support systemof FIG. 31.

FIG. 33 is a head-end view of the patient positioning support system ofFIG. 31.

FIG. 34 is a foot-end view of the patient positioning support system ofFIG. 31.

FIG. 35 is a top view of the patient positioning support system of FIG.31.

FIG. 36 is a right side view of the patient positioning support systemof FIG. 31, wherein the patient support structure has been rolled25-degrees toward the left side of the table.

FIG. 37 is an enlarged view of the head-end of the patient positioningsupport system of FIG. 32, with portions broken away.

FIG. 38 is an enlarged view of the foot-end of the patient positioningsupport system of FIG. 32, with portions broken away.

FIG. 39 is a reduced perspective view of the patient positioning supportsystem of FIG. 1, with the patient support structure positioned so as tomaximally flex the hips and legs of a patient thereon.

FIG. 40 is a right side view of the patient positioning support systemof FIG. 39.

FIG. 41 is a top view of the patient positioning support system of FIG.39.

FIG. 42 is a head-end view of the patient positioning support system ofFIG. 39.

FIG. 43 is a foot-end view of the patient positioning support system ofFIG. 39.

FIG. 44 is an enlarged cross-section of the patient positioning supportsystem of FIG. 39, with the cross-section being taken along the line44-44 of FIG. 41, and with portions broken away.

FIG. 45 is an enlarged perspective view of the patient positioningsupport system of FIG. 39.

FIG. 46 is an enlarged top perspective view of the patient positioningsupport system of FIG. 39.

FIG. 47 is another enlarged perspective view of the patient positioningsupport system of FIG. 39, with portions broken away.

FIG. 48 is a perspective view of the patient positioning support systemof FIG. 39, wherein the prone patient support structure is rolled25-degrees toward the left side of the patient positioning supportstructure.

FIG. 49 is a left side view of the patient positioning support system ofFIG. 48.

FIG. 50 is a right side view of the patient positioning support systemof FIG. 48.

FIG. 51 is a top view of the patient positioning support system of FIG.48.

FIG. 52 is a head-end view of the patient positioning support system ofFIG. 48:

FIG. 53 is a bottom view of the patient positioning support system ofFIG. 48.

FIG. 54 is a foot-end view of the patient positioning support system ofFIG. 48.

FIG. 55 is a reduced perspective view of the patient positioning supportsystem of FIG. 1, with the patient support structure positioned so as tomaximally extend the hips and legs of a patient thereon.

FIG. 56 is right side view of the patient positioning support system ofFIG. 55.

FIG. 57A is top view of the patient positioning support system of FIG.55.

FIG. 57B is a bottom view of the patient positioning support system ofFIG. 55.

FIG. 58 is head-end view of the patient positioning support system ofFIG. 55.

FIG. 59 is foot-end view of the patient positioning support system ofFIG. 55.

FIG. 60 is an enlarged view of the foot-end of the patient positioningsupport system of FIG. 56, with portions broken away.

FIG. 61 is an enlarged view of the head-end of the patient positioningsupport system of FIG. 56, with portions broken away.

FIG. 62 is a reduced right side view of the patient positioning supportsystem of FIG. 1, with the prone patient support structure attached tothe lowest possible position of the ladders.

FIG. 63 is an enlarged perspective view of the prone patient positioningsupport structure of FIG. 55, with portions broken away or not shown.

FIG. 64 is a view of FIG. 63 with portions shown in phantom to showadditional detail of the foot-end of the frame.

FIG. 65 is an enlarged view of the patient positioning support structureof FIG. 56, with the base not shown.

FIG. 66 is an enlarged view of the patient positioning support structureof FIG. 4, with the base not shown.

FIG. 67 is an enlarged view of the patient positioning support structureof FIG. 40, with the base not shown.

FIG. 68 is an enlarged overlaid cross-sectional schematic of the patientpositioning support structures of FIGS. 65, 66 and 67 taken along theline 68-68 of FIG. 5.

FIG. 69 is an enlarged view of the patient positioning support structureof FIG. 4 overlaid with an enlarged phantom view of the patientpositioning support structure of FIG. 56, so as to compare changes inthe positions of various parts of the patient positioning supportstructure when moved between the positions shown in FIGS. 4 and 56.

FIG. 70 is an enlarged side view of a joint of the prone patient supportstructure of FIG. 3.

FIG. 71 is another enlarged side view of a joint of the prone patientsupport structure of FIG. 3.

FIG. 72 is yet another enlarged side view of a joint of the pronepatient support structure of FIG. 3.

FIG. 73 is an enlarged side view of the prone patient support structureof FIG. 3, with portions broken away.

FIG. 74 is another enlarged side view of the prone patient supportstructure of FIG. 3, with portions broken away.

FIG. 75 is an enlarged perspective view of a portion of the joint of theprone patient support structure of FIG. 3, with portions not shown.

FIG. 76 is a perspective view of a portion of the joint of FIG. 75.

FIG. 77 is an enlarged perspective view of a component of the joint ofFIG. 75.

FIG. 78 is an enlarged head-end view of the left-side joint and attachedhip-thigh pad of the prone patient support structure of FIG. 3, withportions not shown.

FIG. 79 is an enlarge perspective view of the left-side joint withattached hip-thigh pad, and portions not shown so as to show greaterdetail thereof.

FIG. 80 is an inner side view of the joint of FIG. 79.

FIG. 81 is a top view of the joint of FIG. 79.

FIG. 82 is a rear view of the joint of FIG. 79.

FIG. 83 is a right side view of the joint of FIG. 79.

FIG. 84 is a forward view of the joint of FIG. 79.

FIG. 85 is a reduced perspective view of the patient positioning supportsystem of FIG. 1, including an attached supine patient supportstructure, and positioned to perform a sandwich-and-roll procedure,wherein the supine patient support structure is attached to the base bya standard length ladder.

FIG. 86 is a right-side view of the patient positioning support systemof FIG. 85.

FIG. 87 is a top view of the patient positioning support system of FIG.85.

FIG. 88 is a bottom view of the patient positioning support system ofFIG. 85.

FIG. 89 is a head-end view of the patient positioning support system ofFIG. 85.

FIG. 90 is a foot-end view of the patient positioning support system ofFIG. 85.

FIG. 91A is foot-end view of the patient positioning support system ofFIG. 85, the patient support structures being positioned to begin thesandwich-and-roll procedure to roll a patient over from a supineposition to a prone position.

FIG. 91B is head-end view of the patient positioning support system ofFIG. 91A, wherein the supine patient support structure is attached tothe base by an extended length ladder instead of a standard lengthladder.

FIG. 92A is a foot-end view of the patient positioning support system ofFIG. 91A, wherein the patient support structures has been rolled about25-degrees.

FIG. 92B is a perspective view of the patient positioning support systemof FIG. 92A.

FIG. 92C is a right-side view of the patient positioning support systemof FIG. 92A.

FIG. 93A is a foot-end view of the patient positioning support system ofFIG. 91A, wherein the patient support structures has been rolled about130-degrees.

FIG. 93B is a perspective view of the patient positioning support systemof FIG. 93A.

FIG. 93C is a right-side view of the patient positioning support systemof FIG. 93A.

FIG. 94A is a foot-end view of the patient positioning support system ofFIG. 91A, wherein the patient support structures has been rolled about180-degrees.

FIG. 94B is a perspective view of the patient positioning support systemof FIG. 94A.

FIG. 95 is a right-side view of the patient positioning support systemof FIG. 94A.

FIG. 96 is a top view of the patient positioning support system of FIG.94B.

FIG. 97 is a bottom view of the patient positioning support system ofFIG. 94B.

FIG. 98 is a head-end view of the patient positioning support system ofFIG. 94B.

FIG. 99 is a foot-end view of the patient positioning support system ofFIG. 94B.

FIG. 100 is a perspective view of the patient positioning support systemof FIG. 91A.

FIG. 101 is a right-side view of the patient positioning support systemof FIG. 99.

FIG. 102 is a perspective view of a patient positioning support systemof the present invention, in another embodiment, including a supinepatient support structure attached to a base using standard lengthladders.

FIG. 103 is perspective view of a supine patient support structure ofthe present invention, in one embodiment.

FIG. 104 is a right-side view of the supine patient support structure ofFIG. 103.

FIG. 105 is a top view of the supine patient support structure of FIG.103.

FIG. 106 is a bottom view of the supine patient support structure ofFIG. 103.

FIG. 107 is an enlarged head-end view of the supine patient supportstructure of FIG. 103.

FIG. 108 is an enlarged foot-end view of the supine patient supportstructure of FIG. 103.

FIG. 109 is a top view of the open breaking frame of the supine patientsupport structure of FIG. 103, including a pair of spaced opposedhinges.

FIG. 110 is perspective view of the supine patient support structure ofFIG. 103 attached to a base using extended length ladders.

FIG. 111 is a head-end view of the patient positioning support structureof FIG. 110.

FIG. 112 is a right-side view of the patient positioning supportstructure of FIG. 110, wherein the supine patient support structure isin a lateral-decubitus position.

FIG. 113 is a head-end view of the patient positioning support structureof FIG. 112.

FIG. 114 is a right-side view of the patient positioning supportstructure of FIG. 110, wherein the supine patient support structure isin a hinge down position.

FIG. 115 is a head-end view of the patient positioning support structureof FIG. 114.

FIG. 116 is an enlarged bottom perspective view of a portion of thesupine patient support structure of FIG. 102 showing the spaced opposedhinges.

FIG. 117 is a side view of one the spaced opposed hinges of FIG. 116.

FIG. 118 is a side view of the spaced opposed hinge of FIG. 117 withshrouding not shown, so as to show detail of the worm gear drive of thehinge.

FIG. 119 is a bottom view of the hinge of FIG. 118.

FIG. 120 is a perspective view of the hinge of FIG. 118.

FIG. 121 is a cross-sectional view of the head-end of the patientpositioning support structure of FIG. 5, the cross-section being takenalong the line 121-121 of FIG. 7.

FIG. 122 is an enlarged left side view of the head-end of the patientpositioning support structure of FIG. 23.

FIG. 123 is an enlarged top view of the patient positioning supportstructure of FIG. 122.

FIG. 124 is an enlarged left side view of the foot-end of the patientpositioning support structure of FIG. 23.

FIG. 125 is an enlarged top view of the patient positioning supportstructure of FIG. 124.

FIG. 126 an enlarged perspective view of a vertical translationsubassembly of the base of FIG. 2 showing a first step in attaching astandard length ladder to the vertical translation subassembly.

FIG. 127 is a side view of the vertical translation subassembly of FIG.126.

FIG. 128 is a perspective view of the vertical translation subassemblyof FIG. 126 showing a second step in attaching the ladder to thevertical translation subassembly.

FIG. 129 is a side view of the vertical translation subassembly of FIG.128.

FIG. 130 is a perspective view of the vertical translation subassemblyof FIG. 126 showing a third step in attaching the ladder to the verticaltranslation subassembly.

FIG. 131 is a side view of the vertical translation subassembly of FIG.130.

FIG. 132 is a perspective view of the vertical translation subassemblyof FIG. 126 showing a fourth step in attaching the ladder to thevertical translation subassembly.

FIG. 133 is a side view of the vertical translation subassembly of FIG.132.

FIG. 134 is an illustration showing a perspective view of a patientpositioning support system of the present invention, in anotherembodiment, wherein the patient positioning support system is positionedto begin a sandwich-and-roll procedure, so as to turn over a patientfrom a supine position, on the supine patient support structure of FIG.103, to a prone position, on the prone patient support structure of FIG.3.

FIG. 135 is an illustration showing the patient positioning supportstructure of FIG. 134 after a 180-degree roll has been initiated.

FIG. 136 is an illustration showing the patient positioning supportstructure of FIG. 134 after the 180-degree roll has been completed.

FIG. 137 is an illustration showing the patient positioning supportstructure of FIG. 136 showing removal of a first of the T-pins attachingthe supine patient support structure to the base.

FIG. 138 is an illustration showing the patient positioning supportstructure of FIG. 137 showing removal of a second of the T-pinsattaching the supine patient support structure to the base.

FIG. 139 is an illustration showing the patient positioning supportstructure of FIG. 138 showing a beginning step in removing the supinepatient support structure from the base.

FIG. 140 is an illustration showing the patient positioning supportstructure of FIG. 139 showing an intermediate step in removing thesupine patient support structure from the base.

FIG. 141 is an illustration showing the patient positioning supportstructure of FIG. 140 showing the supine patient support structure fullyremoved from the base.

FIG. 142 is an illustration showing the patient positioning supportstructure of FIG. 141 showing an intermediate step in removing a firstof the standard length ladders from the base.

FIG. 143 is an illustration showing the patient positioning supportstructure of FIG. 142 showing a further intermediate step in removingthe first ladder from the base.

FIG. 144 is an illustration showing the patient positioning supportstructure of FIG. 144 showing the first ladder removed from the base.

FIG. 145 is an illustration showing the patient positioning supportstructure of FIG. 146 showing an intermediate step in removing a secondof the standard length ladders from the base.

FIG. 146 is an illustration showing the patient positioning supportstructure of FIG. 145 showing a further intermediate step in removingthe second ladder from the base.

FIG. 147 is an illustration showing the patient positioning supportstructure of FIG. 146 showing an even further intermediate step inremoving the second ladder from the base.

FIG. 148 is an illustration showing the patient positioning supportstructure of FIG. 147 showing both the first and second ladders removedfrom the base.

FIG. 149 is an illustration showing a perspective view of a patientpositioning support system of the present invention, in still anotherembodiment, including a supine patient support structure attached to abase by a pair of extended-length ladders.

FIG. 150 is an illustration showing the patient positioning supportsystem of FIG. 149, wherein a first of the T-pins has been removed todisconnect the head-end of the supine patient support structure from thebase.

FIG. 151 is an illustration showing the patient positioning supportsystem of FIG. 150, wherein the head-end of the supine patient supportstructure has been raised to a height suitable for a sandwich-and-rollprocedure and the T-pin is being inserted to reconnect the supinepatient support structure to the base.

FIG. 152 is an illustration showing the patient positioning supportsystem of FIG. 151, wherein the foot-end of the supine patient supportstructure has been raised to the height suitable for thesandwich-and-roll procedure and reconnected to the base.

FIG. 153 is an illustration showing the patient positioning supportsystem of FIG. 152, in an intermediate step of connecting a first of apair of standard length ladders to the base, wherein the standard lengthladders are opposed to the extended length ladders.

FIG. 154 is an illustration showing the patient positioning supportsystem of FIG. 153, in a further intermediate step of connecting thefirst standard length ladder to the base.

FIG. 155 is an illustration showing the patient positioning supportsystem of FIG. 154, wherein the first standard length ladder isconnected to the base.

FIG. 156 is an illustration showing the patient positioning supportsystem of FIG. 155, in an intermediate step of connecting the secondstandard length ladder to the base.

FIG. 157 is an illustration showing the patient positioning supportsystem of FIG. 156, showing a further intermediate step of connectingthe second standard length ladder to the base.

FIG. 158 is an illustration showing the patient positioning supportsystem of FIG. 157, showing a still further intermediate step ofconnecting the second standard length ladder to the base.

FIG. 159 is an illustration showing the patient positioning supportsystem of FIG. 158, showing the standard length ladders both attached tothe base and bringing in the prone patient support structure to beattached to the standard length ladders.

FIG. 160 is an illustration showing the patient positioning supportsystem of FIG. 159, showing connecting the foot-end of the prone patientsupport structure to a ladder using a T-pin, such that the foot-ends ofthe prone and supine patient support structures are attached to the sameend of the base.

FIG. 161 is an illustration showing the patient positioning supportsystem of FIG. 160, showing connecting the head-end of the prone patientsupport structure to the second standard length ladder using anotherT-pin.

FIG. 162 is an illustration showing the patient positioning supportsystem of FIG. 161, showing the prone patient support structure fullyconnected to the base and bringing in the torso support structure.

FIG. 163 is an illustration showing the patient positioning supportsystem of FIG. 162, showing an initial step in attaching a torso supportstructure to the prone patient support structure.

FIG. 164 is an illustration showing the patient positioning supportsystem of FIG. 163, showing an intermediate step in attaching the torsosupport structure to the prone patient support structure.

FIG. 165 is an illustration showing the patient positioning supportsystem of FIG. 164, showing the torso support structure attached to theprone patient support structure, wherein the patient positioning supportsystem is configured and arranged to begin the sandwich-and-rollprocedure, such as to roll over a supine patient, on the supine patientsupport structure, to a prone position on the prone patient supportstructure.

FIG. 166 is an illustration showing the patient positioning supportsystem of FIG. 165, showing an intermediate step in such asandwich-and-roll procedure.

FIG. 167 is an illustration showing the patient positioning supportsystem of FIG. 166, showing another intermediate step in thesandwich-and-roll procedure, wherein the roll has progressed fartherthan that shown in FIG. 166.

FIG. 168 is an illustration showing the patient positioning supportsystem of FIG. 167, showing yet another intermediate step in thesandwich-and-roll procedure, wherein the roll has progressed fartherthan that shown in FIG. 167.

FIG. 169 is an illustration showing the patient positioning supportsystem of FIG. 168 after the sandwich-and-roll procedure has beencompleted.

FIG. 170 is a head-end top perspective view of a supine lateral patientsupport in an embodiment.

FIG. 171 is a foot-end top perspective view of the supine lateralpatient support of FIG. 170.

FIG. 172 is a head-end bottom perspective view of the supine lateralpatient support of FIG. 170.

FIG. 173 is an enlarge head-end view of the supine lateral patientsupport of FIG. 170.

FIG. 174 is an enlarged foot-end view of the supine lateral patientsupport of FIG. 170.

FIG. 175 is an enlarged top view of the supine lateral patient supportof FIG. 170.

FIG. 176 is an enlarged right side view of the supine lateral patientsupport of FIG. 170.

FIG. 177 is an enlarged left side view of the supine lateral patientsupport of FIG. 170.

FIG. 178 is an enlarged bottom view of the supine lateral patientsupport of FIG. 170.

FIG. 179 is a head-end top perspective view of a non-breaking supinelateral patient support in one embodiment.

FIG. 180 is a foot-end top perspective view of the non-breaking supinelateral patient support of FIG. 179.

FIG. 181 is a head-end bottom perspective view of the non-breakingsupine lateral patient support of FIG. 179.

FIG. 182 is an enlarge head-end view of the non-breaking supine lateralpatient support of FIG. 179.

FIG. 183 is an enlarged foot-end view of the non-breaking supine lateralpatient support of FIG. 179.

FIG. 184 is an enlarged top view of the non-breaking supine lateralpatient support of FIG. 179.

FIG. 185 is an enlarged right side view of the non-breaking supinelateral patient support of FIG. 179.

FIG. 186 is an enlarged left side view of the non-breaking supinelateral patient support of FIG. 179.

FIG. 187 is an enlarged bottom view of the non-breaking supine lateralpatient support of FIG. 179.

FIG. 188 is a head-end top perspective view of a breaking supine lateralpatient support in an embodiment.

FIG. 189 is a foot-end top perspective view of the breaking supinelateral patient support of FIG. 188.

FIG. 190 is a head-end bottom perspective view of the breaking supinelateral patient support of FIG. 188.

FIG. 191 is an enlarge head-end view of the breaking supine lateralpatient support of FIG. 188.

FIG. 192 is an enlarged foot-end view of the breaking supine lateralpatient support of FIG. 188.

FIG. 193 is an enlarged top view of the breaking supine lateral patientsupport of FIG. 188.

FIG. 194 is an enlarged right side view of the breaking supine lateralpatient support of FIG. 188.

FIG. 195 is an enlarged left side view of the breaking supine lateralpatient support of FIG. 188.

FIG. 196 is an enlarged bottom view of the breaking supine lateralpatient support of FIG. 188.

FIG. 197 is a head-end top perspective view of a prone lateral patientsupport in an embodiment.

FIG. 198 is a foot-end top perspective view of the prone lateral patientsupport of FIG. 197.

FIG. 199 is a head-end bottom perspective view of the prone lateralpatient support of FIG. 197.

FIG. 200 is an enlarge head-end view of the prone lateral patientsupport of FIG. 197.

FIG. 201 is an enlarged foot-end view of the prone lateral patientsupport of FIG. 197.

FIG. 202 is an enlarged top view of the prone lateral patient support ofFIG. 197.

FIG. 203 is an enlarged right side view of the prone lateral patientsupport of FIG. 197.

FIG. 204 is an enlarged left side view of the prone lateral patientsupport of FIG. 197.

FIG. 205 is an enlarged bottom view of the prone lateral patient supportof FIG. 197.

FIG. 206 is a perspective view of a base of the present invention.

FIG. 207 is a perspective view of the base of FIG. 206, including anattached prone patient support structure and an attached supine patientsupport structure.

FIG. 208 is a perspective view of a supine patient support structure forattachment to the base of FIG. 206.

FIG. 209 is a side view of the supine patient support structure of FIG.208.

FIG. 210 is a perspective view of a prone patient support structure forattachment to the base of FIG. 206.

FIG. 211 is a side view of the prone patient support structure of FIG.210.

FIG. 212 is an enlarged outboard perspective view of a verticaltranslation subassembly of FIG. 206.

FIG. 213 is an enlarged inboard perspective view of a verticaltranslation subassembly of FIG. 206.

FIG. 214 is an enlarged side view of a vertical translation subassemblyof FIG. 206.

FIG. 215 is another enlarged side view of a vertical translationsubassembly of FIG. 206.

FIG. 216 is an enlarged top perspective view of a vertical translationsubassembly of FIG. 206.

FIG. 217 is an enlarged inboard view of a vertical translationsubassembly of FIG. 206.

FIG. 218 is an enlarged outboard view of a vertical translationsubassembly of FIG. 206.

FIG. 219 is another enlarged inboard perspective view of a verticaltranslation subassembly of FIG. 206, with attachment ladders attached.

FIG. 220 is a side view of the base of FIG. 206, including an attachedsupine patient support structure, wherein the primary elevators areequally partially outwardly telescoped, the secondary elevators areequally raised to the highest point, and the supine patient supportstructure is substantially parallel with the floor.

FIG. 221 is a side view of the base of FIG. 220, wherein the primaryelevators are equally fully inwardly telescoped or closed, the secondaryelevators are equally lowered to the lowest possible point, and thepatient support structure is lowered to the lowest possible position andis also substantially parallel with the floor.

FIG. 222 is a side view of the base of FIG. 221, including an attachedprone patient support structure, so as to support a patient for asandwich-and-roll procedure to transfer a patient between the prone andsupine patient support structures.

FIG. 223 is a side view of the base and supine patient support structureof FIG. 219, showing the patient support structure tilted in a firstorientation.

FIG. 224 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure tilted in a secondorientation that is opposite to the orientation shown in FIG. 223.

FIG. 225 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure positioned so as tobe substantially parallel with the floor and also in an upwardarticulated or breaking position, and also wherein the primary elevatorsare equally fully inwardly telescoped or closed, the secondary elevatorsare equally lowered to the lowest possible point, and the patientsupport structure is lowered to the lowest possible position and is alsosubstantially parallel with the floor.

FIG. 226 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure positioned so as tobe substantially parallel with the floor and also in a downwardlyarticulated or breaking position, and also wherein the primary elevatorsare equally fully outwardly telescoped or opened, the secondaryelevators are equally raised to the highest possible point, and thepatient support structure is raised to the highest possible position andis also substantially parallel with the floor.

FIG. 227 is a side view of the base and supine patient support structureof FIG. 225, showing the patient support structure tilted in the firstorientation.

FIG. 228 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure in a Trendelenburgposition.

FIG. 229 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure in a Trendelenburgposition and also tilted in a first orientation.

FIG. 230 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure in a reverseTrendelenburg position.

FIG. 231 is a side view of the base and supine patient support structureof FIG. 220, showing the patient support structure in a reverseTrendelenburg position and also tilted in a second orientation oppositeto the first orientation of FIG. 229.

FIG. 232 is a side view of the base of FIG. 206, including an attachedprone patient support structure, wherein the primary elevators areequally telescoped closed, the secondary elevators are equally raised,and the prone patient support structure is substantially parallel withthe floor.

FIG. 233 is a side view of the base of FIG. 232, wherein the primaryelevators are equally partially telescoped open, the secondary elevatorsare fully raised to the highest possible point, and the prone patientsupport structure is substantially parallel with the floor.

FIG. 234 is a side view of the base of FIG. 232, wherein both theprimary and secondary elevators are raised as high as possible, and theprone patient support structure is substantially parallel with thefloor.

FIG. 235 is a side view of the base of FIG. 233, showing the pronepatient support structure in a flexed position wherein the hips andknees of a patient supported thereon would be flexed.

FIG. 236 is a side view of the base of FIG. 233, showing the pronepatient support structure in an extended position wherein the hips andknees of a patient supported thereon would be extended.

FIG. 237 is another side view of the base of FIG. 233, showing the pronepatient support structure in an extended position wherein the hips andknees of a patient supported thereon would be extended.

FIG. 238 is a side view of the base of FIG. 233, wherein the pronepatient support structure is tilted in a first orientation.

FIG. 239 is a side view of the base of FIG. 233, wherein the pronepatient support structure is tilted in a second orientation that isopposite to the first orientation of FIG. 238.

FIG. 240 is a head-end perspective view of a base for supporting apatient support structure in another embodiment.

FIG. 241 is a foot-end perspective view of the base of FIG. 240.

FIG. 242 is an enlarged side view of the base of FIG. 240.

FIG. 243 is an enlarged top view of the base of FIG. 240.

FIG. 244 is another enlarged side view of the base of FIG. 240.

FIG. 245 is an enlarged bottom view of the base of FIG. 240.

FIG. 246 is an enlarged inboard perspective view of the head-endvertical translation subassembly of the base of FIG. 240.

FIG. 247 is an enlarged outboard perspective view of the head-endvertical translation subassembly of the base of FIG. 240.

FIG. 248 is an enlarged inboard perspective view of the foot-endvertical translation subassembly of the base of FIG. 240.

FIG. 249 is an enlarged outboard perspective view of the foot-endvertical translation subassembly of the base of FIG. 240.

FIG. 250 is an enlarged side view of portions of the rotationsubassembly and the secondary elevator portion, with portions brokenaway to show greater detail thereof, of the base of FIG. 240.

FIG. 251 is an enlarged inboard perspective view of a rotation block anda standard length ladder connected thereto of the base of FIG. 240.

FIG. 252 is an enlarged view of the rotation block and the standardlength ladder of FIG. 241, with portions shown in phantom.

FIG. 253 is an enlarged view of an upper reversibly locking ladderattachment member of the rotation block FIG. 241.

FIG. 254 is an enlarged view of lower reversibly locking ladderattachment member of the rotation block FIG. 241.

FIG. 255A is a head-end top perspective view of a prone patient supportstructure in another embodiment, including a torso support structure.

FIG. 255B is another head-end top perspective view of the prone patientsupport structure of FIG. 255A.

FIG. 256 is another head-end top perspective view of the prone patientsupport structure of FIG. 255A.

FIG. 257 is a foot-end top perspective view of the prone patient supportstructure of FIG. 255A.

FIG. 258 is a head-end bottom perspective view of the prone patientsupport structure of FIG. 255A.

FIG. 259 is another head-end bottom perspective view of the pronepatient support structure of FIG. 255A.

FIG. 260 is a foot-end bottom perspective view of the prone patientsupport structure of FIG. 255A.

FIG. 261 is another foot-end bottom perspective view of the pronepatient support structure of FIG. 255A.

FIG. 262A is an enlarged head-end view of the prone patient supportstructure of FIG. 255A.

FIG. 262B is another enlarged head-end view of the prone patient supportstructure of FIG. 255A.

FIG. 263 is an enlarged head-end top view of the prone patient supportstructure of FIG. 255A.

FIG. 264A is an enlarged foot-end view of the prone patient supportstructure of FIG. 255A.

FIG. 264B is another enlarged foot-end view of the prone patient supportstructure of FIG. 255A.

FIG. 265 is an enlarged foot-end top view of the prone patient supportstructure of FIG. 255A.

FIG. 266A is a reduced left side view of the prone patient supportstructure of FIG. 255A.

FIG. 266B is another reduced left side view of the prone patient supportstructure of FIG. 255A.

FIG. 267A is a reduced right side view of the prone patient supportstructure of FIG. 255A.

FIG. 267B is another reduced right side view of the prone patientsupport structure of FIG. 255A.

FIG. 268A is a reduced top view of the prone patient support structureof FIG. 255A.

FIG. 268B is another reduced top view of the prone patient supportstructure of FIG. 255A.

FIG. 269A is a reduced bottom view of the prone patient supportstructure of FIG. 255A.

FIG. 269B is another reduced bottom view of the prone patient supportstructure of FIG. 255A.

FIG. 270 is another head-end top perspective view of the prone patientsupport structure of FIG. 255A, with portions of the torso supportstructure removed to show greater detail of the frame.

FIG. 271 is a foot-end top perspective view of the prone patient supportstructure of FIG. 270.

FIG. 272 is a reduced top view of the prone patient support structure ofFIG. 270.

FIG. 273 is a reduced bottom view of the prone patient support structureof FIG. 270.

FIG. 274 is a reduced right side view of the prone patient supportstructure of FIG. 270.

FIG. 275 is a reduced left side view of the prone patient supportstructure of FIG. 270.

FIG. 276 is an enlarged head-end top perspective view of the head-endportion of the prone patient support structure of FIG. 255A, and thetorso support structure showing greater detail thereof.

FIG. 277 is another enlarged head-end top perspective view of thehead-end portion of the prone patient support structure of FIG. 255A,and the torso support structure, with portions cut away and in phantom,to show greater detail thereof.

FIG. 278 is another enlarged head-end top perspective view of thehead-end portion of the prone patient support structure of FIG. 255A,and the torso support structure, with portions cut away and in phantom,to show greater detail thereof.

FIG. 279A is an enlarged view of a portion of the head-end portion ofthe prone patient support structure of FIG. 278.

FIG. 279B is another enlarged view of a portion of the head-end portionof the prone patient support structure of FIG. 278.

FIG. 280 is an enlarged view of a hip-thigh pad attached to a pad mountof a joint of the prone patient support structure of FIG. 255A.

FIG. 281A is an enlarged view of a joint of the prone patient supportstructure of FIG. 255A.

FIG. 281B is a view of the joint of FIG. 281A with portions shown inphantom.

FIG. 282 is an enlarged side perspective view of the prone patientsupport stucture of FIG. 255A with portions broken away and portionsshown in phantom to show greater detail thereof.

FIG. 283 is an view of the prone patient support structure of FIG. 282with portions broken away and portions shown in phantom to show greaterdetail thereof.

FIG. 284A is an enlarged view of joint of the prone patient supportstructure of FIG. 282 with portions shown in phantom to show greaterdetail thereof.

FIG. 284B is another enlarged view of joint of the prone patient supportstructure of FIG. 282 with portions shown in phantom to show greaterdetail thereof.

FIG. 284C is another enlarged view of joint of the prone patient supportstructure of FIG. 282 with portions broken away to show greater detailthereof.

FIG. 285A is an enlarged perspective view of a portion of the joint ofthe prone patient support structure of FIG. 282.

FIG. 285B is another view of the joint of FIG. 285A.

FIG. 286 is another perspective view of the joint of FIG. 285A.

FIG. 287 is another perspective view of the joint of FIG. 285A.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

As required, detailed embodiments of the present invention are disclosedherein; however, it is to be understood that the disclosed embodimentsare merely exemplary of the invention, which may be embodied in variousforms. Therefore, specific structural and functional details disclosedherein are not to be interpreted as limiting, but merely as a basis forthe claims and as a representative basis for teaching one skilled in theart to various employ the present invention in virtually anyappropriately detailed structure.

Patient Positioning Support System Components and Operation

Referring now to FIGS. 1-119, a patient positioning support system,structure, apparatus or table according to the invention is generallydesignated by the reference numeral 5, in one embodiment. FIG. 1 is atop perspective view of the patient positioning support system 5 of thepresent invention, which includes a base, generally 10, and a patientsupport structure or table top, generally 15 ⁰, such as but not limitedto at least one of a prone patient support structure 15, a supinepatient support structure 15′ and an alternatively sized, shaped andconfigured patient support structure. The patient positioning supportsystem 5 includes head and foot-ends, left and right-hand sides, and topand bottom sides, which for discussion purposes are denoted relative tothe sides of a patient's body when the patient is positioned in a proneposition on the prone patient support structure 15.

The patient support system 5 also includes a plurality of axes,including but not limited to roll, pitch, yaw and vertical translationaxes, which are respectively denoted by R, Pn, Yn and Vn, wherein ndenotes or identifies a specific axis, and all of which are most easilyseen in FIGS. 1-3. The roll axis R extends longitudinally along a lengthof the patient support system 5, and intersects the head- and foot-ends16 and 16′, respectively, of the base 10. The base head-end 16 includesa first vertical translation axis V1 and a first yaw axis Y1. Similarly,the base foot-end 16′ includes a second vertical translation axis V2 anda second yaw axis Y2. Finally, P1 the patient support structure 15 ⁰includes three pitch axes, wherein the first pitch axis P1 is P1associated with a patient's hips, the second pitch axis P2 is associatedwith the head-end 18 of the patient support structure 15 ⁰, and thethird pitch axis P3 is associated with the foot-end 19 of the patientsupport structure 15 ⁰.

Generally, the roll, pitch and yaw axes, R, Pn and Yn, of the patientpositioning support system 5 are axes about which rotational movement ofat least a portion of the patient positioning support system 5 canoccur, and therefore are functionally analogous to the roll, pitch andyaw axes of an airplane. The vertical translation axes Vn are associatedwith up and down lifting and lowering the head- and foot-ends 18, 19 ofthe patient support structure 15 ⁰.

In various embodiments, the movements of the patient positioning supportsystem 5, with respect to the head and foot-ends, left and right-handsides, and top and bottom sides, as well as with respect to the roll,pitch, yaw and vertical translation axes, R, Pn, Yn and Vn,respectively, can be one or more of synchronous or sequential, active orpassive, powered or non-powered, mechanically linked or synchronized bysoftware, and continuous (e.g., within a range) or incremental, and suchas is described in greater detail below.

Base Structure and Function

FIG. 2 is a perspective view of a base 10 of the patient positioningsupport system 5, in an exemplary embodiment. The base 10 may also bereferred to as a base structure or base subassembly. The base 10 isadapted to support the patient support structure 15 ⁰ above the floor F.The base 10 includes structure that is adapted to lift and lower, tilt,roll, rotate and, additionally or alternatively, angulate at least aportion of the patient support structure 15 ⁰ relative to the floor F,so as to position a patient's body in a desired position for a medicalprocedure, such as is described in greater detail below.

The base 10 includes at least one vertical translation subassembly 20,also referred to as a vertical elevator, a telescoping pier, a verticaltranslator, or the like. In an exemplary embodiment, such as that shownin FIGS. 2, 7, 8 and 24, the base includes a vertical translationsubassembly 20 at each of its head- and foot-ends 16, 16′; wherein thepair of spaced opposed vertical translation subassemblies 20 joined by alongitudinally extending supportive cross-bar 25. In the illustratedembodiment, the vertical translation subassemblies 20 are generallyidentical and face one another, or are mirror images of one another,though this is not required in all embodiments. It is foreseen that oneor both vertical translation subassemblies 20 may have an alternativestructure. For example, the telescoping riser of the verticaltranslation subassemblies (described below) may be off-set, or notcentered over the foot or base portion, such as is described elsewhereherein. In another example, one or both of the vertical translationsubassemblies 20 may be constructed such as described in U.S. Pat. Nos.7,152,261, 7,343,635, 7,565,708, 8,060,960, or U.S. Patent ApplicationNo. 60/798,288, U.S. patent application Ser. No. 12/803,173, U.S. patentapplication Ser. No. 12/803,192, or U.S. patent application Ser. No.13/317,012, all of which are incorporated by reference herein in theirentireties.

The cross-bar 25 is a substantially rigid support that joins and holdsthe vertical translation subassemblies 20 in spaced opposed relation toone. In a further embodiment, the cross-bar 25 is non-adjustable.However, in some other embodiments, the cross-bar 25 is removable ortelescoping, so that the vertical translation subassemblies 20 can bemoved closer together, such as for storage. In certain embodiments, thecross-bar 25 is longitudinally adjustable so that the verticaltranslation subassemblies 20 can be moved closer together or fartherapart, such as, for example, to support or hold different patientsupport structures 15 of various lengths or configurations, such as butnot limited to interchangeable or modular patient support structures 15.In certain other embodiments, there patient positioning support system 5does not include a cross-bar 25. Numerous cross-bar 25 variations areforeseen. It is foreseen that the cross-bar 25 may be telescoping, andadditionally or alternatively removable, such that the cross-bar 25 canbe shortened, or removed, such as for storage of the base 10.

Regardless of the presence or absence of any such cross-bar 25 describedherein or foreseen, the vertical translation subassemblies 20 aresubstantially laterally non-movable with respect to one another, eithercloser together or farther apart, once a patient support structure 15 ⁰has been attached to or joined with the base 10, and during use oroperation of the patient positioning support system 5.

Referring again to FIG. 2, each vertical translation subassembly 20includes a lower portion 30, an upper portion 35 and a verticaltranslation axis V1 or V2 that extends upwardly from the floor F so asto be substantially perpendicular thereto. The lower portion 30 includesa lower support structure 40, such as a base portion or a foot, and ariser assembly 45. The riser assembly 45 includes a mechanical drivesystem or mechanism (not shown), such as is known in the art that liftsand lowers the upper portion 35 along the respective verticaltranslation axis V1, V2 and relative to the floor F. As mentioned above,the riser assembly 45 may be off-set with respect to the lower supportstructure 40.

At least one of the vertical translation subassembly upper portions 35includes a rotation subassembly, generally 50, that enables tilting androlling of the patient support structure 15 ⁰ about the roll axis R,such as is described below. As is described in greater detail below, theroll axis R extends longitudinally between the upper portions 35.

The rotation subassembly 50 includes a mechanical rotation motor 55, arotation shaft 56 and a rotation or ladder connection block 57. Therotation motor 55 may be any motor known in the art that is strongenough to rotate the patient support structure 15 ⁰ about the roll axisR and optionally to lock the patient support structure 15 ⁰ in a tiltedorientation with respect to the floor F. Harmonic motors areparticularly useful as the rotation motor due to their strength.

Alternatively, the rotation subassembly 50 may be constructed such asdescribed in U.S. Pat. Nos. 7,152,261, 7,343,635, 7,565,708, 8,060,960,or U.S. Patent Application No. 60/798,288, U.S. patent application Ser.No. 12/803,173, U.S. patent application Ser. No. 12/803,192, or U.S.patent application Ser. No. 13/317,012, all of which are incorporated byreference herein in their entireties. Numerous variations are foreseen.Non-motorized rotation subassemblies 50 are also foreseen.

The motor 55 is enclosed or shrouded by a housing 60, with front andback portions 61, 62, a top portion 63, opposed side portions 64 and anoptional front plate or rotation plate 65, so as to be protectedthereby. Accordingly, the rotation shaft 56 extends through the housingfront portion 61, as is described below.

Referring now to FIG. 121, which is a top cross-section of the patientpositioning support system 5 taken along line 121-121 of FIG. 7, therotation shaft 56 is generally cylindrical in shape, with a circularcross-section, and is substantially parallel with the floor F. Therotation shafts 56, of the opposed vertical translation subassemblyupper portions 35, are each movable with respect to an associatedvertical translation axes V1 or V2, so as to be locatable or placeableat a selectable distance above the floor F. When the opposed rotationshafts 56, of two vertical translation subassemblies 20, are equallyspaced above the floor F, such as is shown in FIGS. 4 and 40, therotation shafts 56 are also substantially coaxial with the roll axis R.However, when the rotation shafts 56 is raised or lowered, such that theshafts 56 are no longer equally spaced from the floor F, such as isshown in FIGS. 24 and 32, the rotation shafts 56 intersect roll axis Rbut a not coaxial with the roll axis R.

Each rotation shaft 56 includes inner and outer portions, 70, 71,respectively. The rotation shaft inner portion 70 is engaged by andcooperates with the rotation motor 55, so as to be rotatable in eitherthe clockwise or counter-clockwise directions, such as is illustrated inFIGS. 91a-94a , FIGS. 134-136, and FIGS. 165-169.

The outer portion 71 of the rotation shaft 56 includes a substantiallycylindrical side surface 76 with opposed side surface openings (notshown), an outer or inboard face 77 and a through-channel 78 that joinsthe side surface openings and extends through the outer portion 71 so asto form a bore-like structure. Thus, the interior of the through-channel78 is joined with the side surface 76 by the surface openings. As notedbelow, the through-channel 78 of the rotation shaft outer portion 71 issized to receive a yaw pin therethrough, so as to join the shaft outerportion 71 with the associated rotation block 57.

The rotation shaft outer portion 71 extends out of the housing 60 and inan inboard direction toward the upper portion 35 of the opposed verticaltranslation subassembly 20. The outer portion 71 is joined with therotation block 57, also referred to as a connection member or firstportion, by a yaw pin 79, inner connector shaft, peg, post or connector,that extends through the shaft outer portion through-channel 78 and intothe rotation block 57. Each yaw pin 79 is coaxial with a respective yawaxis Y1 or Y2, so as to enable the rotation block 57 to rotate at leasta small amount the yaw axis Y1 or Y2. One or more bushings 80 sleeve atleast a portion of the yaw pin 79, such as is shown in FIGS. 13-22 and121, so as to reduce friction and to secure the yaw pin 79 to the shaftouter portion 71.

In some embodiments, a rotation plate 65 joins the inner and outerportions 70 and 71 of the rotation shaft 56. The rotation plate 65 mayalso be referred to as an optional front plate 65 of the housing 60. Therotation plate 65 may be integral with or separate from the rotationshaft 56. In some embodiments, the housing front portion 61 includes,and is optionally integral with, the rotation plate 65, which functionsas a face plate that covers and protects the inboard side 85 of therotation motor 55. It is foreseen that the patient positioning supportsystem 5 may include no front or rotation plate 65.

The base 10 includes a pair of connection subassemblies 75, forreversible attachment with a patient support structure 15 ⁰. Eachconnection subassembly 75 includes a respective rotation block 57, aladder 100 or 100′ and a T-pin 101. The T-pin 101 includes a rod portion102 and a handle portion 103. In the illustrated embodiment, connectionsubassemblies 57 are each joined with one of the vertical translationsubassemblies 20, such as but not limited to by a respective rotationsubassembly 50. The rotation block 57, also referred to as a ladderconnection block 57, is reversibly attachable or connectable to at leastone ladder structure 100, 100′, which in turn is reversibly attachableto an end of the patient support structure 15 ⁰, such as is describedbelow. The connection subassemblies 57 provide structure for removablyconnecting, attaching or joining the base 10 with a patient supportstructure 15 ⁰. In the illustrated embodiment, the head-end and foot-endrotation blocks 57 are substantially identical, or mirror images of oneanother; however, it is foreseen that one or both of the blocks 57 mayhave an alternative size, shape and additionally or alternativelyconfiguration.

The connection subassemblies 57 provide structure for at least somevertical translation, or height adjustment, of an attached patientsupport structure 15 ⁰, such as is described below. Further, the twoconnection subassemblies 57 cooperate with each other and optionallywith the patient support structure 15 ⁰, to provide structure for afail-safe structure or mechanism, such as is described below. Thefail-safe substantially blocks incorrect detachment of an attachedpatient support structure 15 ⁰, wherein such incorrect detachment canresult in catastrophic collapse of at least a portion of the patientpositioning support system 5 and patient injury.

Referring to FIGS. 13-22 and 121, each rotation block 57 is generallyblock-shaped and includes spaced opposed front and rear faces 105, 110,spaced opposed top and bottom faces 115 and spaced opposed end faces120. The faces may also be referred to as sides, ends, surfaces orportions. In the illustrated embodiment, the faces of each pair ofopposed faces, such as the front and rear faces 105, 110, the top andbottom faces 115, and the end faces 120, are substantially parallel withone another; but, it is foreseen that this may not be the case in otherembodiments.

The rotation block front face 105 includes a front surface 123 with acentrally located front opening 125 and at least one rail-receivinggroove 127 or channel. In the illustrated embodiment, the front 105includes a pair of parallel rail-receiving grooves 127, which aredenoted as first and second rail-receiving grooves 128 and 129,respectively, with reference t the figures. In some circumstances, thefirst rail-receiving groove 128 may also be referred to as an upperrail-receiving groove, and the second rail-receiving groove 129 may bereferred to as a lower rail-receiving groove 129.

Each rail-receiving groove 127 includes a contoured inner surface 130and an outer lip 131. The inner surface 130 and lip 131 are sized,shaped and configured to receive an upper rail 133 of a ladder 100, 100′therein. In the illustrated embodiment, the upper rail 133 issubstantially cylindrical with a circular cross-section. Accordingly,the groove inner surface 130 and lip 131 are sized, shaped andconfigured to reversibly receive therein and to engage the cylindricalupper rail 133. In some embodiments, the contoured inner surface 130 isadapted to frictionally engage the upper rail 133. In an exemplaryalternative embodiment, the ladder upper rail 133 is box-shaped with asquare cross-section, and the rail-receiving groove 127 includes acomplementary box shape with an inner surface 130 having planar surfaceportions and a lip 131 that are adapted to engage and retain the upperrail 133.

The rotation block rear face 110 includes a rear surface 134 and acentrally located rear opening 135. The surface 134 is generally flatand planar, but may include some non-planar portions, in someembodiments.

The block front and rear openings 125, 135 are joined by a blockthrough-bore 140 or channel that is sized, shaped and adapted to receiveat least a portion of the rotation shaft 56 therein, whereby by theblock 57 is attached to the rotation shaft 56. In some embodiments, therotation shaft 56 extends through the block through-bore 140.

The rotation block through-bore 140 includes an inner surface 145, withupper, lower and side surfaces 150, 155 and 160, respectively, and oneor more engagement surfaces 165 that are shaped to engage one or moreportions of the rotation subassembly 50, such as but not limited to therotation shaft outer portion 71. For example, as shown in FIGS. 15, 16and 22, the engagement surfaces 165 include at least one partiallycylindrical bushing engagement surface 170 and an optional substantiallyplanar engagement surface 175 (see FIGS. 15 and 22). While in theillustrated embodiment the rotation block through-bore 140 is generallybox-shaped, it is foreseen that the through-bore 140 may have othershapes, such as but not limited to cylindrical, conical and prismaticshapes.

The rotation block 57 is joined with the rotation shaft outer portion71. Namely, the shaft outer portion 71 extends into and optionallythrough the block through-bore 140. A yaw pin, peg or post 180 attachesthe through-bore 140 with the shaft outer portion 71. The yaw pin 79extends through the shaft through channel 78 and into the side surface160 of the block through-bore 140. One or more of the engagementsurfaces 165 contacts and engages the surface 183 of the yaw pin 79. Oneor more bushings 80 may be received over or around the yaw pin 79, so asto provide spacing.

Returning to FIGS. 14, 22 and 121, in some embodiments, one or morebushings 80 are received over the yaw pin 79. The bushings 80 providefor at least some engagement between the yaw pin 79 and the bushingengagement surfaces 170 and optionally additional engagement surfaces165, 175 of the block through-bore 140. As shown in FIG. 14, thebushings 80 space or separate the rotation shaft 56 from the innersurface 145 of the block through-bore 140. Further, the bushings 80 canprovide a snug and secure fit or connection between the rotation shaft56 and the rotation block 57. While the yaw pin 79 is substantiallycylindrical with a circular cross-section, it is foreseen that the yawpin 79 may be any other useful three-dimensional shape, such as a coneor a prism, optionally with a cylindrical portion.

The yaw pin 79 is coaxial with a respective yaw axis Y1 or Y2, and isadapted to enable or allow rotational movement of the rotation block 57about the respective yaw axis Y1 or Y2. In addition, as shown in FIGS.29-30 and 122-125, each of the rotation blocks 57 is attached to arespective shaft 75 so as to provide a space 180 or distance between theblock rear face 110 and the housing front 61. This space 180 isparticularly important, as described below, because the rotation block57 is adapted to yaw or rotate about the associated yaw axis Y1 or Y2,such as is indicated by the double-headed directional arrow 185. Thisyaw motion brings a portion of the block rear face 110 closer to thehousing front 61, and the space 180 must be sufficient to prevent thestructures from contacting or bumping into each other, wherein suchcontact between the block rear face 110 and the housing front 61 couldinhibit free, or smooth, rotation of the block 57 with respect to theroll axis R. Accordingly, in preferred embodiments, the space 180 issufficient to substantially block or prevent contact between the blockrear face 110 and the housing front 61 when the respective rotationblock 57 rotates about the respective yaw axis Y1 or Y2.

Referring to FIGS. 13-22 and 121, each rotation block 57 is attached toor joined with a respective rotation shaft outer portion 71 of thevertical translation subassembly 20. The rotation shafts 56 of theopposed vertical translation subassemblies 20 are rotated insynchronization, toward either the left-hand side or right-hand side ofthe patient positioning support system 5 and also at the same speed.Each of the rotation shafts 56 rotates an attached block 57 clockwise orcounter-clockwise, which in turn rotate a pair of attached ladders 100or 100′ about the roll axis R. As the ladders 100 or 100′ rotated inunison, they cooperatively rotate a patient support structure 15 ⁰ thatis attached or suspended therebetween.

The block through-bore 140 is located so as to enable the rotation shaftouter portion 71 to smoothly and evenly rotate the ladder connectionblock 57 with respect to the roll axis R. A shaft through-channel 78pierces or extends through the shaft outer portion 71. The yaw pin 79extends through both the rotation block through-bore 140 and therotation shaft through-channel 78 so as to join the rotation shaft outerportion 71 with the ladder connection block 57.

The yaw pin 79 is substantially coaxial with the associated yaw axis Yn,so as to enable the ladder connection block 57 to be rotated,articulated or pivoted either clockwise or counter-clockwise about theassociated yaw axis Yn, such as is indicated by directional arrow 185.For example, in FIGS. 19, 20 and 121, the yaw axis Yn extends out of thepage, so as to be substantially perpendicular to the plane of the page.In the illustrated embodiment, the cylindrical yaw pin 79 includes acircular cross-section. It is foreseen that the yaw pin 79 may have anyother shaped cross-section that enables the ladder connection block 57to sufficiently pivot about the yaw axis Yn, and thereby to preventbuckling of the patient positioning support system 5 when the patientsupport structure 15 ⁰ is placed in a Trendelenburg or reverseTrendelenburg position and is also rolled or tilted about the roll axisR, such as is shown in FIGS. 28 and 36. For example, in someembodiments, a universal joint-like structure replaces or is substitutedfor the yaw pin 79.

Each rotation block 57 includes at least one ladder connection structure190, or ladder connection subassembly, which is complementary in size,shape and configuration with a block connection structure 191, or blockconnection subassembly, of a ladder 100, 100′. The block connectionstructures 191, of the ladders 100, 100′, are described below.Cooperation between the block's ladder connection structure 190 and theladder's block connection structure 191 enables reversible attachment,engagement or mating of a ladder 100, 100′ to the block 57.

Referring to FIGS. 13-22, the ladder connection structure 190, of therotation block 57, includes a rail-receiving groove 127 (describedabove) and a pair of ladder engagement pegs 195. As shown in FIG. 16,each of the engagement pegs 195 extends outwardly from an associatedrotation block end face 120. The pegs 195 are positioned on the endfaces 120 so as to be coaxially aligned with one another. Further, thepair of pegs 195 are positioned so as to cooperate with the associatedrail-receiving groove 127. In preferred embodiments, the rotation block57 includes two ladder connection structures 190. Accordingly, therotation block 57 includes two pairs of engagement pegs 195, such asupper and lower pairs 200, 205 of pegs 195, or a first pair 200 of pegs195 and a second pair 205 of pegs 195. The upper pair 200 of pegs 195 isassociated with the upper or first rail-receiving groove 128, and thelower pair 205 of pegs 195 is associated with the lower or secondrail-receiving groove 129.

The engagement pegs 195 of each pair 200 or 205 of pegs 195 are alignedwith one another and spaced from an adjacent ladder connection groove201 so as to enable connection of a ladder 100 to the ladder connectionblock 57. For example, the upper pegs 200 are coaxial with one anotherand spaced from the first rail-receiving groove 128, and the lower pegs205 are coaxial with one another and spaced from the secondrail-receiving groove 129, such that a ladder 100 or 100′ can be engagedeither with the upper pair of pegs 200 and the upper groove 128 or withthe lower pair of pegs 205 and the lower groove 129. Engagement orconnection of a rotation block 57 and a ladder 100 or 100′ is describedin greater detail below.

The ladders 100, 100′ are substantially rigid and facilitate or provideattachment of a patient support structure 15 ⁰, such as but not limitedto a prone patient support structure 15 and a supine patient supportstructure 15′, to the base 10 of the patient positioning support system5.

In the illustrated embodiment, the patient positioning support system 5includes at least one pair of ladder structures or ladders. The laddersmay be a provided in a variety of lengths, such as but not limited to astandard and non-standard lengths. Ladders having a standard length aredenoted by the number 100, and ladders having a non-standard length aredenoted by the number 100′. Non-standard length ladders 100′ include alength that is relatively longer or shorter than a standard lengthladder 100. FIG. 10 illustrates an exemplary standard length ladder 100.An exemplary pair of extended length ladders 100′ is shown in FIGS.110-115.

It is noted that in the illustrated embodiment, the ladders 100, 100′are provided in one of two lengths, a standard length ladder 100 andnon-standard length ladder 100′, wherein the non-standard length ladder100′ includes an extended length, or a length greater than that of thestandard length ladder 100. It is foreseen that ladders 100′ of other,non-standard lengths can be provided. In the illustrated embodiment,pairs of matched ladders 100 or 100′, or two ladders 100 or 100′ havingsubstantially the same length, are attached to the opposed rotationblocks 57. It is foreseen that miss-matched pairs of ladders 100, 100′could be attached to the rotation blocks 57.

Each ladder 100, 100′ includes a pair of rigid space opposed ladder sidemembers, wherein standard length side members are denoted by the number231 and non-standard length side members are denoted by the number 231′.The pair of ladder side members 231, 231′ are joined at or near theirupper ends 232 or 232′ also referred to as connection ends, by the upperrail 133 described above. At their lower ends 233 or 233′, the ladderside members 231, 231′ are joined by a second or lower rail 234, 234′.In some embodiments, the ladder 100 or 100′ may include additionalstabilizing rails (not shown).

Each ladder side member 231, 231′ includes inner and outer faces orsides 235, 235′ and 236, 236′, respectively, and inboard and outboardfaces or sides 237, 237′ and 238, 238′, respectively. As shown in FIGS.1 and 102, when a ladder 100, 100′ is attached to the base 10, theladder connection block or rotation block 57 and also, or alternatively,to a patient support structure 15 ⁰, the inboard faces 237, 237′ arepositioned toward or closer to the patient support structure 15 ⁰.Similarly, the outboard faces 238, 238′ are positioned toward theassociated, attached or connected vertical translation subassembly 20.

At the upper ends 232, 232′, the ladder side members 231, 231′ eachinclude an engagement peg receiving groove 239, 239′. The engagement pegreceiving groves 239, 239′ are cut into the inner faces 235, 235′ of theladder side members 231, 231′, and extend from the outboard side 238,238′ toward the inboard side 237, 237′ so as to provide a peg-receivingchannel 240, 240′ with an opening 241, 241′ and a peg-engaging chamber243, 243′. The peg-receiving channel 240, 240′ is sized and shaped toremovably slidingly receive a ladder engagement peg 195 therein. The twochannels 240, 240′ are generally or substantially parallel with oneanother, and are located to as to engage a pair of ladder engagementpegs 195 such as but not limited to pair 200 and pair 205, such as areshown in FIG. 16. The peg-engaging chamber 243, 243′ is sized and shapedto lockingly engage the peg 195 received in the channel 240, 240′.

Prior to reversibly or releasably connecting, joining or attaching apatient support structure 15 ⁰ to the base 10, a pair of ladders 100,100′ must be attached to the base 10. FIGS. 126-133 and FIGS. 152-159illustrate attaching a standard sized ladder 100 to an upper pair ofpegs 200 of a rotation block 57, the steps of which are substantiallysimilar for attachment of a non-standard length ladder 100′, such as butnot limited to an extended length ladder 100′.

In a first step, shown in FIGS. 126-127, the ladder channel openings241, 241′ are aligned with the block pegs 195, such as the upper pair200 of pegs 195, such as is indicated by the directional arrow denotedby the numeral 248. The openings 241, 241′ are correctly aligned withthe upper pair of pegs 200 by orienting, tilting or tipping the ladder100 such that the lower rail 234 is located more inboard than the upperrail 133. Accordingly, when in this position, the lower rail 234 isspaced or located higher from the floor F than the upper rail 133.

In a second step, shown in FIGS. 128-129, the peg-receiving channelopenings 241, 241′ are placed, installed or engaged around the upperpegs 200, such that the upper pegs 200 are effectively inserted into theopenings 241, 241′. The peg-receiving channels 240, 240′ are then slid,moved or placed around the pegs 200, such that the pegs 200 are slid ormoved along or through the channels 240, 240′, such as by tilting orrotating the lower end of the ladder 100 in an outboard direction, suchas is indicated by the directional arrow denoted by the numeral 246. Theladder 100 is moved or tilted until it comes into a vertically alignedorientation or configuration, such as that shown in FIGS. 130 and 131.While the pegs 200 are becoming engaged, the ladder upper rail 133 fitsinto and engages the ladder connection groove 127 on the front face 105of the rotation block 57, and the outer surface 205 of the upper rail133 frictionally engages the groove surface 203. When the ladder 100 isin the vertical orientation, the pegs 200 are substantially engaged by,or located or received within, the respective channel chambers 243,243′.

It is noted that a pair of opposed ladders 100 or 100′ attached to therespective vertical translation subassemblies 20 provide a fail-safemechanism that prevents improper disconnection of an attached or engagedpatient support structure 15 ⁰ from the base 10. This fail-safemechanism includes two components. First, the ladders 100 and 100′cannot be disconnected from the base 10 unless no patient supportstructure 15 ⁰ is attached thereto. Second, the ladders 100 and 100′must be disconnected or removed from the base 10 by performing theattachment steps in reverse order. Accordingly, the ladder lower ends233, 233′ must be tilted in an inboard direction, before the respectiveladder upper ends 232, 232′ can be disconnected or disengaged from therotation block 57. Other fail-safe mechanisms, structures orsubassemblies are foreseen.

In some embodiments, the rotation block 57 includes at least one lockingmechanism, structure or device, generally 250, adapted to lock theladder upper rail 133 in the engaged rail-receiving groove 127. In theseembodiments, the locking mechanism 250 can be actuated or engaged as anoptional step in attaching the ladder 100, 100′ to the rotation block57. FIGS. 132-133 illustrate attaching a ladder 100 to a rotation block57. Referring to FIGS. 15-20 and 126-133, the rotation block 57 includesupper and lower pairs of lock mechanisms 250. Each lock mechanism 250includes an inner locking portion 255 and a handle 260 that extendsoutwardly from the front face 105 of the rotation block 57. The innerlocking portion 255 can be swiveled into and out of the opening 265 ofthe associated rail-receiving groove 127, or ladder connection groove,by manually turning or rotating the associated handle 260 on the frontface 105 of the rotation block 57, such that the lock 250 is engaged orclosed. It is foreseen that the lock mechanisms 250 could be motorizedand controlled by software or otherwise mechanically actuateable.

Closing the locks 250, such as is shown in FIGS. 132 and 133, preventsor blocks removal, disengagement, detachment or disconnection of theupper rail 133 from the engaged, attached or connected firstrail-receiving groove 128. To disconnect the ladder 100, 100′ from thefirst rail-receiving groove 128, the lock mechanisms 250 must be opened,disengaged or de-actuated. In embodiments of the patient positioningsupport system 5 including a lock mechanism 250, it is foreseen that thelock mechanism 250 must be substantially opened prior to attachment orinstallation of a ladder 100 or 100′ with the rotation block 57.

With reference to FIGS. 13, 21, 85-100 and 134-169, it is noted that thepatient positioning support system 5 is adapted, configured and arrangedfor reversible attachment of up to two ladders 100, 100′, such as upperand lower ladders, to each rotation block 57. Accordingly, two suchladders 100, 100′ attached to a single rotation block 57 aresubstantially vertically opposed to one another and also co-planar withone another. In contrast, a pair of ladders 100 or 100′ attached to thetwo opposed rotation blocks 57 at either end of the base 10, such as apair of ladders 100 or 100′ attached to either the first rail-receivinggrooves 128 or the lower rail-receiving grooves 129, are substantiallyopposed to and parallel with one another. When the ladder 100, 100′ isattached to the block 57, a plane that runs parallel with and throughthe ladder side members 231, 231′ is substantially perpendicular to thefloor F. Alternative configurations are foreseen.

In some embodiments, the rotation block 57 is sized, shaped andconfigured such that when two ladders 100, 100′ attached thereto, theirupper ends 232, 232′ kiss or contact one another. It is foreseen that,in some embodiments, the upper ends 232, 232′ may not contact oneanother, depending upon the locations of the upper and lower pairs 200,205 of ladder engagement pegs 195.

Attaching two ladders 100, 100′ to each of the rotation blocks 57 of thepatient positioning support system 5 enables attachment of two patientsupport structures 15 ⁰, such as for example a prone patient supportstructure 15 and a supine patient support structure 15′, such as isdescribed elsewhere herein. For example, a patient can be positioned ona first of two patient support structures 15 ⁰, such as for a firstsurgical procedure, and then transferred to the second of the twopatient support structures 15 ⁰, such as for performing a secondsurgical procedure with the patient in a different body position. Suchtransferring of a patient between the two patient support structures 15⁰ can be performed in numerous ways, including but not limited to asandwich-and-roll procedure, such as is described below.

The ladders 100, 100′ are sized, shaped, configured and arranged forattachment to a patient support structure 15 ⁰ in addition to the base10. Each ladder side member 231 or 231′ includes a plurality of spacedthrough-bores 270, 270′ joining its respective inner and outer faces235, 235′ and 236, 236′. The through-bores 270, 270′ of the opposedladder side members 231 or 231′ are sized, shaped and located or alignedsuch that pairs of opposed through-bores 270, 270′ can removably orreversibly slidingly receive the rod portion 102 of a T-pin 101therethrough. For example, with reference to FIG. 10, through-bores 275and 280 are coaxially aligned such that a single, or the same, T-pin 101is receivable therethrough (e.g., a single T-pin 101 is receivablethrough both of the through-bores 275 and 280).

Additional aspects of attaching the ladders to the patient supportstructure 15 ⁰ are described in greater detail below, with respect tothe structure for the patient support structure 15 ⁰. Further,additional information regarding ladders can be found in U.S. patentapplication Ser. No. 13/507,618, filed Jun. 18, 2012, which isincorporated herein by reference.

Roll, Vertical Translation and Yaw Axes

As noted above, the base includes a plurality of axes, including alongitudinally extending roll axis R, at least one vertical axis denotedby the letter Vn, wherein n is an integer indicating, identifying ordenoting a particular or specific vertical axis, and at least one yawaxis denoted by the letter Yn, wherein n is an integer indicating aparticular or specific yaw axis. The base 10 is configured and arrangedfor movement with respect to these axes, such as is described below andelsewhere herein.

Roll Axis

The roll axis R extends longitudinally along a length of the patientpositioning support system 5. In particular, the roll axis R extendsbetween the outer portions 71 of the rotation shafts. In an exemplaryembodiment, when the upper portions 35 of the opposed verticaltranslation subassemblies 20 are located substantially equidistant fromthe floor F, such as is shown in FIG. 4, the roll axis R issubstantially coaxial with the rotation shafts 56. In another exemplaryembodiment, when the upper portions 35 are not equidistant from thefloor F, such as is shown in FIGS. 24 and 32, the roll axis R intersectsthe rotation shaft outer portions 71.

The base 10 is adapted to tilt, roll, turn over, or rotate the patientsupport structure 15 ⁰ such as but not limited to the prone patientsupport structure 15 and the supine patient support structure 15′ aboutor around the roll axis R. The patient support structure 15 ⁰ can bereversibly rolled or tilted an amount or distance of between about1-degree and about 237-degrees, such as relative to a plane intersectingthe roll axis R wherein the plane is parallel with the floor F, or suchas relative to a starting position associated with a plane parallel withthe floor F, wherein the plane intersects with the roll axis R. Forexample, in some embodiments, the patient support structure 15 ⁰ may betilted a distance of about 5-degrees, about 10-degrees, about15-degrees, about 20-degrees, about 25-degrees, about 30-degrees, about35-degrees, or about 40-degrees about the roll axis R, relative to astarting position associated with a plane parallel with the floor F,wherein the plane intersects with the roll axis R, so as to provideimproved access to a surgical site. In a further embodiment, the patientsupport structure 15 ⁰ may be tilted a distance of about 45, 50, 55, 60,65, 70, 75, 80, 85, 90, 95 or 100-degrees about the roll axis R,relative to a starting position associated with a plane parallel withthe floor F, wherein the plane intersects with the roll axis R. In someembodiments, the patient support structure 15 ⁰ may be tilted a distanceof about 110, 115, 120, 125, 130, 135, 140, 145, 150, 155, 160, 165,170, 175 or 180-degrees about the roll axis R, relative to a startingposition associated with a plane parallel with the floor F, wherein theplane intersects with the roll axis R. In some embodiments, the patientsupport structure 15 ⁰ may be rolled a distance of more than 180-degreesabout the roll axis R, relative to a starting position associated with aplane parallel with the floor F, wherein the plane intersects with theroll axis R. In some embodiment, the patient support structure 15 ⁰ canbe rolled clockwise or counter-clockwise, or toward either the left-handor the right-hand side with respect to the roll axis R. In somecircumstances, both the prone and supine patient support structure 15and 15′ may be attached to the base 10 and rolled together with respectto the roll axis R.

FIGS. 91A, 92A, 93A and 94A illustrate rolling the prone and supinepatient support structures 15, 15′ about the roll axis R, in oneembodiment, wherein the patient support structures 15, 15′ arereversibly attached to a base 10, such as but not limited to during asandwich-and-roll procedure. In FIG. 91A, the supine patient supportstructure 15′ is below the roll axis R and the prone patient supportstructure 15 is above the roll axis R. In FIG. 92A, the prone and supinepatient support structures 15 and 15′ are tilted about the roll axis R,or toward the right of the page, a distance of about 25-degrees. FIGS.92B and 92C provide alternative views of tilting the prone and supinepatient support structures 15 and 15′ about 25-degrees around the rollaxis R. Then, either the prone and supine patient support structures 15,15′ can be locked in this position, such as for improved access to asurgical site, or they can be rolled farther, such as is describedherein. FIGS. 93A-93C illustrate rolling the prone and supine patientsupport structures 15 and 15′ even farther about the roll axis R, adistance of about 130-degrees, such as if the patient is being rolledover in a sandwich-and-roll procedure. FIGS. 94A, 94B and 95 show thepositions of the prone and supine patient support structures 15, 15′after completion of a 180-degree roll. In this position, the supinepatient support structure 15′ is located above the roll axis R and theprone patient support structure 15 is below the roll axis R, and apatient thereon would be facing downward toward the floor F.

In some embodiments, the patient positioning support system 5 isconfigured and arranged to roll the prone and supine patient supportstructures 15, 15′ a full 360-degrees about the roll axis R in at leastone direction, so as to return to the orientation shown in FIG. 91A.

In other embodiments, the base 10 is adapted to roll the patient supportstructures 15, 15′ backwards, or in a reverse direction, about the rollaxis R, so as to be rolled a suitable distance, so as to position thepatient in an orientation associated therewith, such as but not limitedto the positions shown in FIGS. 91A through 95.

Vertical Axes

Each vertical translation subassembly 20 includes a vertical translationaxis, which is denoted by V1 or V2. Vertical translation or movement, ofat least a portion of the patient positioning support apparatus 5 mayoccur along one or both of the vertical translation axes V1 and V2. Forexample, the vertical translation subassembly 20 on the right side ofFIG. 2 raises and lowers the associated upper portion 35 along the firstvertical translation axis V1. Similarly, the vertical translationsubassembly 20 on the left side of FIG. 2 raises and lowers theassociated upper portion 35 along the second vertical translation axisV2. Such vertical translation may be synchronous or asynchronous, suchas is described in greater detail below.

Each vertical translation subassembly 20 includes maximum and minimumtranslation or lift distances. The maximum lift distance is the maximumamount, most or highest the riser assembly 45 can be telescopedoutwardly or upwardly, or extended. For example, the maximum liftdistance is the highest that the rotation shaft outer portion 71 can bespaced from or above the floor F. In an exemplary embodiment, FIG. 4shows both of the upper portions 35 positioned at substantially equaldistances above the floor F, wherein the distance is about equal to themaximum lift distance described above, and the roll axis R issubstantially parallel with the floor F. In another example, FIG. 50shows both of the vertical translation subassemblies 20 in a maximallyoutwardly telescoped, raised, opened or fully open configuration,orientation or position with respect to their respective verticaltranslation axis V1, V2 and also with respect to the floor F.

The minimum lift distance is the minimum amount, least, farthestdownward, or the lowest the riser assembly 45 can be telescopeddownwardly or inwardly, contracted or closed. For example, the minimumlift distance is the lowest height that the rotation shaft outer portion71 can be spaced, located or extended above the floor F. In analternative example, shown in FIGS. 1 and 45, both of the verticaltranslation subassemblies 20 are in a maximally inwardly telescoped,lowered, closed, contracted, or fully closed configuration, orientationor position, with respect to their respective vertical translation axisV1, V2 and also with respect to the floor F, such that the upperportions 35 are both located as close to the floor F as possible.

The vertical translation subassemblies 20 are sized, shaped, arranged,configured, or adapted to move, translate, or lift and lower therotation shaft outer portion 71 vertically, between the maximum andminimum lift positions. In some embodiments, this vertical translationis incremental. For example, in one embodiment, the vertical translationsubassembly 20 includes a ratchet mechanism that controls the intervalsof lift, and an operator must select a number of discreet intervals forthe upper portion 35 to be moved. In other embodiments this verticaltranslation is non-incremental, or continuous, between the maximum andminimum lift positions or distances. For example, in an embodiment, thevertical translation subassembly 20 includes a screw-drive mechanismthat smoothly lifts and lowers the upper portion 35 an amount determinedby an operator, wherein the amount of movement includes no discreetintervals or distances.

Depending upon the desired positioning of the patient, the verticaltranslation subassemblies 20 can be moved in the same direction or inopposite directions. Further, the vertical translation subassemblies 20can translate their respective upper portions 35 the same distance ordifferent distances.

In yet another embodiment, both of the vertical translationsubassemblies 20 are positionable at substantially equally telescopedpositions, relative to their respective vertical translation axis V1, V2and the floor F, and wherein the telescoped positions are between thefully open and fully closed positions. When in this position, the rollaxis R is substantially parallel with the floor F.

In another embodiment, the vertical translation subassemblies 20 aremovable in opposite directions, and additionally or alternatively,positionable at different heights. For example, the vertical translationsubassemblies 20 can be moved and placed such that one of the upperportions 35 is located farther from the floor F, or higher than, theopposed upper portion 35. For example, FIG. 23 shows the head-end upperportion 35 fully opened, and the foot-end upper portion 35 is closed,such that attached prone patient support structure 15 is positioned in areverse Trendelenburg position. In this example, the upper portions 35do not both intersect a single plane running parallel with the floor F;or the upper portions 35 are non-parallel with one another, relative tothe floor F.

FIG. 32 shows another example, wherein the head-end vertical translationsubassembly 20 is telescoped closed, and the foot-end verticaltranslation subassembly 20 is fully opened, such that the attached pronepatient support structure 15 is in a Trendelenburg position. In yetanother example, both of the vertical translation subassemblies 20 arepositionable at substantially unequally telescoped positions, relativeto their respective vertical translation axis V1, V2 and the floor F,and wherein the telescoped positions are between the fully open andfully closed positions. When in this position, the roll axis R is notsubstantially parallel with the floor F. Numerous positions of thepatient support structure 15 ⁰ are foreseen, wherein the upper portions35 are raised to various different heights relative to the floor F.

The vertical translation subassemblies 20 can be operated singly ortogether, and synchronously or asynchronously. For example, one of thevertical translation subassemblies 20 is telescoped, expanded, lifted ormoved, while the opposed vertical translation subassembly 20 is nottelescoped or moved, or is held or maintained immobile. In anotherexample, both of the vertical translation subassemblies 20 are moved inthe same or opposite directions at the same time, and at the same ordifferent rates of vertical movement. Numerous variations are foreseen.

Operation of the vertical translation subassemblies 20 is generallycoordinated and controlled electronically, or synchronized, such as by acomputer system that interacts with one or more motion sensors (notshown) associated with various parts of the patient positioning supportsystem 5 and the motorized drives, such as is known in the art. However,it is foreseen that one or more portions or subsystems of the verticaltranslation subassemblies 20 may be operated manually. Further, in somecircumstances, the electronic control of the patient positioning supportsystem 5, or the drive system, can be turned off, or at leasttemporarily disconnected, so that one or more portions of the patientpositioning support system 5 can be moved manually. For example, duringa sandwich-and-roll procedure, such as is described elsewhere herein, atleast the step of rolling the patient over is usually performed manuallyby two, three or preferably four or more operators or medical staff,after the drive system, or a clutch, has been temporarily disconnectedor released, so as to ensure that the patient is not injured during theprocedure. After the roll is completed, the clutch is re-engaged, sothat the patient positioning support system 5 can mechanically performadditional movement and positioning of the patient.

Yaw Axes

Each of the vertical translation subassemblies 20 includes a yaw axisYn. For example, in the embodiments shown in FIGS. 2, 37 and 38, thevertical translation subassemblies 20 include the yaw axes Y1 and Y2,respectively. When the patient support structure 15 ⁰, such as but notlimited to a prone patient support structure 15, is substantiallyparallel with the floor F, and not rolled about the roll axis R, such asis shown in FIG. 4, the yaw axes Y1 and Y2 are substantiallyperpendicular to the floor F and substantially parallel with thevertical axes V1 and V2. However, when the patient support structure 15⁰ is and rolled about the roll axis R, so as to be non-parallel with thefloor F, such as is shown in FIGS. 50-54, the yaw axes Y1 and Y2 are notperpendicular to the floor F or with the vertical axes V1 and V2.

The yaw axes Yn enable rotational movement thereabout of at least aportion of the patient positioning support system 5. Such rotationalmovement prevents buckling or collapse of the patient positioningsupport system 5 when the patient support structure 15 ⁰, such as butnot limited to a prone or supine patient support structure 15, 15′, isplaced in certain positions, such as but not limited to a Trendelenburgor a reverse Trendelenburg position, in conjunction with rotation aboutthe roll axis R, such as is described in greater detail below.

As described below, the rotation block 57 is sized, shaped and arrangedto as to rotate or pivot about the associated yaw axis Yn. As theconnection block 57 pivots about the yaw axis Yn, the rear face 110 doesnot substantially contact either the housing front 150 or the rotationplate 65. In some embodiments, the rotation block 57 is spaced asufficient distance from the rotation plate 65 and additionally oralternatively the housing front 150 so as to substantially prevent suchcontact therebetween from happening.

In alternative or additional embodiments, the rotation block 57 and therotation subassembly 50 are sized, shaped and configured to allow orenable the rotation block 57 to be rotated a distance about the yaw axisYn, so as to prevent the patient positioning support system 5 fromcollapsing during certain positioning and rolling of the patient supportstructure 15 ⁰, such as described elsewhere herein, and also such thatthe distance of rotation about the yaw axis Ynis not sufficient for therear face 110 to contact the housing front 150 of the rotation plate 65.

Movement of the Patient Positioning Support Structure with Respect tothe Roll, Yaw and Vertical Translation Axes; Active versus PassiveMovement; Simultaneous Versus Sequential Movement

The patient positioning support system 5 is adapted for movement withrespect to the roll, yaw and vertical translation axes R, Yn and Vn,respectively. With respect to two or more of these axes, such movementmay occur simultaneously or sequentially, or occurs at substantially thesame time.

In an exemplary embodiment of simultaneous movement with respect to twoor more of roll, yaw and vertical translation axes R, Yn and Vn, one ofthe vertical translation subassemblies 20 may telescope upwardly, so asto lift the attached end of the patient support structure 15 ⁰, such asbut not limited to a prone or supine patient support structure 15 or15′, while the rotation subassembly 50 simultaneously or concurrentlyrolls the patient support structure 15 ⁰ a distance of between about5-degress and about 25-degress toward the left-hand side of the patientpositioning support system 5.

In other embodiments, movement with respect to two or more of these axesis sequential. The rotation subassembly 50 is movably attached to theconnection subassembly 57 so as to enable both rotational movement of atleast a portion of the connection subassembly 57 about the roll axis Rand also rotational movement of at least a portion of the connectionsubassembly 57 about an associated yaw axis Yn. In particular, therotation subassembly 50 is attached to the respective rotation block 57by an attachment that allows that rotation block 57 to pivot about theyaw axis Yn. It is foreseen that the connection subassembly 57 can bejoined or attached to the rotation subassembly 50 using a varietystructures or mechanisms known in the art, so long as rotation of theconnection subassembly 57 with respect to the roll and yaw axes R, Yn ismaintained.

Preferably, such rotation about both the roll and yaw axes R, Yn issmooth and non-incremental. However, in certain embodiments, rotationabout the roll axis R is incremental, including a plurality ofselectable incremental stops. Further, rotation about the roll axis Rmay be active, such as mechanically actuated or driven, or rotationabout the roll axis R may be passive, such as manually rolling thepatient support structure 15 ⁰ about the roll axis R.

In the illustrated embodiment, such as is shown in FIGS. 14 and 121, therotation shaft outer portion 71 extends into and optionally through therotation block through-bore or through-channel 165, and is attached,joined or fixed thereto. Rolling or rotation of the rotation shaft 56,due to actuation of the rotation subassembly 50, causes rotation of therotation block 57 about the roll axis R, in either a clockwise or acounterclockwise direction. Rolling of the rotation shaft 56 can rotatethe rotation block 57 a distance of between about 1-degree and about237-degrees in either a clockwise or a counter clockwise direction, suchthat a patient on the patient support structure 15 ⁰ can be rolled overor tilted, such as is described elsewhere herein.

Patient Support Structure Components and Operation

As described above, the patient positioning support system 5 includes atleast one patient support structure 15 ⁰, such as but not limited toprone and supine patient support structures 15, 15′. In someembodiments, the patient positioning support system 5 includes one ormore additional patient support structures, such as but not limited to apatient support structure adapted to hold a patient of a different size,such as but not limited to a pediatric patient, an extra-tall adultpatient, and an obese patient. In some embodiments, the patientpositioning support system 5 includes one or more additional patientsupport structures 15 ⁰, such as but not limited to a patient supportstructure adapted for a specific medical procedure, some of which aredescribed in greater detail below. It is foreseen that a patient supportstructure 15 ⁰ may be configured and arranged to include one or moremodular or interchangeable portions.

The patient support structure 15 ⁰ is suspended above the floor F. In afurther embodiment, the patient support structure 15 ⁰ is attached toand supported by or suspended by the base 10.

Each patient support structure 15 ⁰, such as but not limited to theprone and supine patient support structures 15, 15′ described below,includes a plurality of pitch axes, which are denoted by Pn, wherein nis an integer that indicates or denotes a specific or particular pitchaxis. For example, as shown in FIGS. 3 and 103, the prone and supinepatient support structures 15, 15′ each include first, second and thirdpitch axes, which are denoted by P1, P2 and P3, respectively. The firstpitch axis P1 is located between and spaced from the second and thirdpitch axes P2 and P3. All three pitch axes P1, P2 and P3 runsubstantially perpendicular to a longitudinal axis of the respectivepatient support structure 15 ⁰ as well as substantially parallel withone another. Depending upon the position of the patient supportstructure 15 ⁰ relative to the floor F, the pitch axes P1, P2 and P3 maybe either parallel with the floor F or intersect the floor F.

The patient support structure 15 ⁰ is adapted, configured and arrangedfor rotational movement about each of the pitch axes P1, P2 and P3. Ingeneral, the first pitch axis P1 is located so as to be associated withrotational movement at or near a patient's hips. The first pitch axis P1enables positioning of a patient in a prone position such that the hipsare flexed or extended. In contrast, the second and third pitch P2 andP3 axes are associated with rotational movement of the patient supportstructure 15 ⁰ about the respective axis relative to the base 10, andwherein the second pitch axis P2 is associated with head-end of thepatient support structure 15 ⁰ and P3 is associated with the foot-end ofthe patient support structure 15 ⁰. This enables placing the patient ineither a Trendelenburg position or a reverse Trendelenburg position,such as is described in greater detail below.

Prone Patient Support Structure

The prone patient support structure 15 is sized, shaped, configured andarranged, or otherwise adapted, for supporting a patient (not shown) ina prone, or face-down, position during a medical procedure, such as butnot limited to imaging and surgical procedures. FIGS. 1, 3-9, 23-101,121-125, 134-148 and 159-169 illustrate an exemplary prone patientsupport structure 15, in one embodiment. Alternatively sized, shaped,configured and arranged, or otherwise adapted prone patient supportstructures 15 are foreseen.

As is most easily seen in FIG. 3, the prone patient support structure 15of the present invention includes a first pitch or pivot axis P1 that isassociated with a virtual pivot point 282. In some embodiments, thevirtual pivot point 282 is a pair of virtual pivot points, which may belocated so as to be spaced and opposed to one another. The first pitchaxis P1 intersects the virtual pivot points 282. At least a portion ofthe prone patient support structure 15 is rotatable about the firstpitch axis P1 wherein such rotational movement is indicated by thedouble-headed directional arrow 284.

In the exemplary embodiment of FIG. 3, the virtual pivot points 282 areeach located at a point of contact between the patient's skin and asurface of a hip-thigh pad 286, also referred to as pelvic pads orpelvic support pads. The hip-thigh pads 286 are sized, shaped andlocated so as to hold, support and pad the hips or pelvis of a pronepatient (not shown) supported on the prone patient support structure 15.

In other embodiments, the virtual pivot points 282 and the associatedfirst pitch axis P1 are located above or below the exemplary virtualpivot points 282 and first pitch axis P1 depicted in FIG. 3.Additionally or alternatively, in some embodiments, the virtual pivotpoints 282 and the associated first pitch axis P1 are located moretoward the head-end 288 or more toward the foot-end 290 of the patientpositioning support structure 5, than the exemplary virtual pivot points282 and first pitch axis P1 depicted in FIG. 3.

The prone patient support structure 15 includes second and third pitchor pivot axes P2 and P3 that are associated with its head and foot-ends,and which are generally denoted by the numerals 288 and 290respectively. The prone patient support structure 15 is sized, shapedand arranged to provide for rotation of the prone patient supportstructure 15 about the second pitch axis P2, such as is indicated by thedouble-headed directional arrow 292. For example, the prone patientsupport structure 15 is adapted to rotate about the second pitch axis P2relative to the floor F. Similarly, the prone patient support structure15 is sized, shaped and arranged to provide for rotation of the pronepatient support structure 15 about the third pitch axis P3, such as isindicated by the double-headed directional arrow 294. For example, theprone patient support structure 15 is adapted to rotate about the thirdpitch axis P3 relative to the floor F.

The maximum amounts of rotation at P2 and P3 is determined by, ordependent upon, the minimum and maximum heights of the verticaltranslator upper ends, such as but not limited to the min and maxheights of the connection subassembly connection to the rotationsubassembly.

The prone patient support structure 15 is adapted to pivot, rotate ormove about P2 and P3 when reversibly placed in and moved betweennumerous positions relative to the floor F. For example, in a firstposition, or orientation, the patient support structure 15 is positionedsuch that the upper body portion thereof, or the torso of a patientsupported thereon is substantially parallel with the floor F. In asecond position, the upper body portion of the prone patient supportstructure 15, or the torso of a patient supported thereon, issubstantially non-parallel with the floor F. The patient supportstructure 15 is movable between the first and second positions. Forexample the prone patient support structure 15 may be moved to andplaced in Trendelenburg and reverse Trendelenburg positions, such as ashown in FIGS. 31 and 23, respectively. When moving the prone patientsupport structure 15 between the first and second positions, the pronepatient support structure 15 must rotate about both P2 and P3.Generally, this pivoting movement about P2 and P3 is simultaneous,thought not necessarily at the same rate. It is foreseen that suchmovement may be incremental or non-incremental, such as but not limitedto between maximally angled Trendelenburg and reverse Trendelenburgpositions relative to the floor F. Rotation about the second and thirdpitch axes P2 and P3 is discussed in greater detail below. It is notedthat an infinite number of non-incremental positions exist between theminimum and maximum positions. It is also noted that a finite number ofincremental positions exist between the minimum and maximum positions.It is noted that in some embodiments the supine patient supportstructure 15′ is movable in a substantially similar manner to that ofthe prone patient support structure 15.

Prone Patient Support Structure: Frame

The prone patient support structure 15 includes an open fixed frame 296that is suspended above the floor F. The frame 296 is substantiallyrigid and strong, and able to withstand substantial forces appliedthereto. Additionally, as much of the frame 296 as possible isradiolucent, so as to not interfere with imaging.

In the illustrated embodiment, the frame 296 is attachable to the base10, such that the base 10 holds or suspends the frame 296 above thefloor F. However, it is foreseen that the frame 296 can also besuspended above the floor F using any other useful structure known inthe art, such as but not limited to an attachment structure thatconnects the frame 296 with the ceiling, with a wall, or with acombination thereof. In some embodiments, the frame 296 is suspended orheld above the floor F using another base known in the art. Numerousconfigurations are foreseen. Further, the illustrated base 10, or anyother useful base known in the art, can also suspend either the pronepatient support 15 alone or both the prone and supine patient supports15 and 15′ together above the floor F. As described below, the prone andsupine patient support structures 15, 15′ can both be connected to anddisconnected from the base 10.

The prone patient support structure frame 296 includes left-hand andright-hand sides, generally 275 and 300 respectively, a head-end 302 anda foot-end 304. When a prone patient is supported on the prone patientsupport structure 15, the left side of the patient is near or at theframe left-hand side 298. Similarly, the patient's right side of thepatient is located near or at the frame right-hand side 300.

The frame 296 also includes left-hand and right-hand frame portions 306and 308, respectively, which are spaced and opposed to one another, andextend longitudinally with respect to the prone patient supportstructure 15. The left-hand and right-hand frame portions 306, 308 aresubstantially parallel with one another. At the frame head-end 302, theleft-hand and right-hand frame portions 306, 308 are joined by ahead-end frame member 310. Similarly, at the frame foot-end 304, theleft-hand and right-hand frame portions 306, 308 are joined by afoot-end frame member 312. Accordingly, the frame head-end and foot-endframe members 310 and 312 hold or maintain the left-hand and right-handframe portions 306, 308 in spaced relation to one another.

Each of the head-end and foot-end frame members 310, 312 includes anattachment structure 314 structure adapted for attachment to the base 10and also to enable angulation of the patient support structure 15relative to the base 5 at the second and third pivot axes P2 and P3.Attachment of the patient support structure 15 head-end 302 to avertical translation subassembly 20 using a T-pin 101 and the like isdescribed below. When installed, the T-pin 101 associated with the framehead-end 310 is substantially coaxial with the second pitch axis P2.Similarly, when installed, the T-pin 101 associated with the framefoot-end 312 is substantially coaxial with the third pitch axis P3.

The head-end frame member 310 includes an attachment structure 314 thatincludes a T-pin engaging member 316 with a through-bore 318 extendingtherethrough. The through-bore 318 is sized and shaped to reversiblyslidingly receive a T-pin 101 therethrough. In the illustratedembodiment, the T-pin engaging member 316 is a substantially cylindricaltube-like portion. However, it is foreseen that the T-pin engagingmember 316 my have any other useful shape known in the art. In theillustrated embodiment, the head-end attachment structure 314 isattached to a ladder 100 or 100′ by aligning the T-pin engaging memberthrough-bore 318 with a pair of ladder through-bores, such asthrough-bores 275 and 280, such that the through-bore 318 is locatedbetween the through-bores 275 and 280 and the three through-bores 275,280 and 318 are substantially coaxial. Then, a T-pin 101 is insertedinto and through the three through-bores 275, 280 and 318 so as to beengaged thereby. With respect to the head-end 302 of the frame 296, whenthe T-pin 101 and through-bores 275, 280 and 318 are engaged, they arealso coaxial with the second pitch axis P2.

The frame foot-end 304 is connected or attached to a second or foot-endvertical translator 20 in a substantially similar manner to the framehead-end 302. Namely, the foot-end frame member 312 includes anotherattachment structure 314 that also includes a T-pin engaging member 316with a through-bore 318 extending therethrough. The through-bore 318 issized and shaped to reversibly slidingly receive a T-pin 101therethrough. In the illustrated embodiment, the T-pin engaging member316 is a substantially cylindrical tube-like portion. However, it isforeseen that the T-pin engaging member 316 my have any other usefulshape known in the art. In the illustrated embodiment, the foot-endattachment structure 314 is attached to a ladder 100 or 100′ by aligningthe T-pin engaging member through-bore 318 with a pair of ladderthrough-bores, such as through-bores 275 and 280, such that thethrough-bore 318 is located between the through-bores 275 and 280 andthe three through-bores 275, 280 and 318 are substantially coaxial.Then, a T-pin 101 is inserted into and through the three through-bores275, 280 and 318 so as to be engaged thereby. With respect to thefoot-end 304 of the frame 296, when the T-pin 101 and through-bores 275,280 and 318 are engaged, they are also coaxial with the third pitch axisP3.

Referring to FIGS. 23-38, the T-pin engaging members 316 are sized,shaped and configured to pivot or rotate about an engaged T-pin 101, soas to rotate, pivot, angulate or articulate about the associated pitchaxis P2 or P3. For example, with reference to FIG. 29, the head-endT-pin engaging member 316 pivots counter-clockwise about the engagedT-pin 101, as indicated by the arrow 292. In another example, withreference to FIG. 30, the foot-end T-pin engaging member 316 pivotscounter clockwise about another T-pin 101, as indicated by the arrow294. In yet another example, with reference to FIG. 37, the head-endT-pin engaging member 316 pivots clockwise about the engaged T-pin 100,as indicated by the arrow 292. In still another example, with referenceto FIG. 38, the foot-end T-pin engaging member 316 pivots clockwiseabout the T-pin 101, as indicated by the arrow 294.

An exemplary T-pin 101 is shown in FIGS. 11 and 11A. It is noted thatT-pins 101 are used to connect both of the head- and foot-ends 302, 304of both the prone and supine patient support structures 15, 15′ to thevertical translation subassemblies 20 using the ladders 100 andoptionally the ladders 100′, but such T-pins 101 are not shown in manyof the attached figures. Each T-pin 101 includes a shaft 102, a handle103 and a locking member 104. As shown in FIG. 11A, the locking memberis positionable in a locking position, shown in phantom, and anon-locking position. It is foreseen that the patient support structures15, 15′ may include alternatively configured attachment structures 314and T-pins 101. Additional information about T-pins can be found inco-pending U.S. patent application Ser. No. 13/507,618, filed Jun. 18,2012.

Translation Compensation Subassembly

As noted above, the patient support structure 15 ⁰ can be moved tonumerous positions wherein said structure is or is not parallel with thefloor F. Since the base 10 is fixed in position by the cross-bar 25,such that the vertical translation subassemblies 20 cannot move relativeto one another, a change in the height of one or both of the verticaltranslation subassemblies 20 changes the distance between the rotationsubassemblies 50 (e.g., rotation blocks 57, yaw pins 79, etc.).Accordingly, when this distance increases or decreases, the length ofthe patient support structure 15 ⁰ must change a similar orcomplementary amount. The patient support structure 15 ⁰ changes itslength and therefore includes a translation compensation subassembly320, described below.

Referring now to FIGS. 63 through 66, at their foot-ends 304, theleft-hand and right-hand frame portions 306, 308 include an in-frame orin-line translation compensation subassembly, generally 320, alsoreferred to as a lateral translation compensation subassembly. In anexemplary embodiment, each translation compensation subassembly 320includes a translation bar 322 that joins the foot-end 260 of theassociated frame portion 306 or 308 with the foot-end frame member 312.The translation bars 310 are adapted to telescope outwardly and inwardlyfrom the associated frame portions 306, 308, so as to effectivelylengthen and shorten the foot-end 304 of the frame 296 when the frame296 is moved between an orientation generally parallel with the floor Fand Trendelenburg and reverse Trendelenburg positions, or when the frame296 is moved such that the roll axis R moves between orientations thatare parallel and non-parallel with the floor F. The translationcompensation subassembly 320 also includes a translation driver 324located within the frame portions 306 or 308 that actuates thetelescoping of the translation bar 322.

The frame 296 of the present invention may be adapted to be used with avariety of translation compensation subassemblies, such as but notlimited to those described in U.S. Pat. Nos. 7,565,708, 8,060,960, orU.S. Patent Application No. 60/798,288, U.S. patent application Ser. No.12/803,173, U.S. patent application Ser. No. 12/803,192, or U.S. patentapplication Ser. No. 13/317,012, instead of the illustrated translationcompensation subassembly 320. However, the in-frame compensationsubassembly 320 of the present invention provides the advantage of a lowprofile.

The translation compensation subassembly 320 of the present invention isactively driven and infinitely adjustable between a maximally outwardlytelescoped configuration and a closed configuration. Passive translationcompensation mechanisms are foreseen. Translation compensationmechanisms that are not in-line with the frame 296 are also foreseen. Itis noted that the supine patient support structure 15′ may include asimilar translation compensation subassembly 320.

Pivot-Shift Mechanism

Referring again to FIG. 3, as well as FIGS. 65-84, the prone patientsupport structure 15 includes a pair of spaced opposed radially slidingor gliding joints, generally 326, that provide a pivot-shift mechanismfor moving the pelvic pads 286.

The joints 326 are generally centrally located along a length of theframe 296 and cooperate with the frame 296 of the prone patient supportstructure 15. For example, in the embodiment shown in FIG. 3, the joints326 are located along the length of the frame 296 so as to be associatedwith the first pitch axis P1. The joints 326 are spaced and opposed toone another, so as to allow a portion of a patient's body to hangdownwardly therebetween. For example, a patent's belly may hangdownwardly between the joints 326 when the patient is positioned in aprone position on the prone patient support structure 15. Further, thejoints 326 are substantially parallel with one another.

Referring to FIG. 72 each joint 326 includes a virtual pivot point 248and an arc of motion, denoted by AOM, that is spaced a distance, orradius r, from the virtual pivot point 248. The radius r extends fromthe virtual pivot point 248 to the arc of motion AOM in a plane that issubstantially perpendicular to the first pitch axis P1. The radius rdefines at least a portion of the arc of motion AOM.

Each joint 326 includes a first joint component 328, a second jointcomponent 330, and a third joint component 332. In the illustratedembodiment, the first and third joint components 328, 332 each include aplurality of ratchet teeth that are adapted such that the teeth 328 ofthe first joint component 328 cooperatively engage the teeth 332 of thethird joint component. The third joint component 322 is connected to amotor 333 that actively drives clockwise and counterclockwise rotationof the third joint component 332, whereby the third joint competent 332actuates rotary movement of the first joint component 328 with respectto the second joint component 330. It is noted that the first and secondjoint components 328 and 330 each include a guide track component with aweight-bearing gliding surface, 328 a and 330 a respectively, where inthe guide track components cooperatively sliding mate to enable thefirst joint component 328 to glide or slide, and therefore rotate, withrespect to the second joint component 330 and also about the respectivevirtual pivot point 248. Alternative joint configurations and componentsare foreseen so long as the function of moving the joint 326 withrespect to the virtual pivot point 248 in maintained.

The joints 326 are movable along the arc of motion AOM. Since eachhip-thigh pad 286 is attached to the first joint components 328.Accordingly, movement of the first joint component 328 associated with ahip-thigh pad 286, with respect to the virtual pivot point 248 and thearc of motion AOM glidingly or slidingly moves, pivots or rotates thehip-thigh pad 286 about the virtual pivot point 248 and also a portionof the hip-thigh pad 286 along the arc of motion AOM, such as isdescribed in greater detail below.

Still referring to FIG. 72, it is noted that a joint 326 can beconfigured such that the virtual pivot point 248 is located higher orlower, or more to the left-hand or the right-hand side of the page, thandepicted, such as but not limited to exemplary alternative virtual pivotpoints 248 a, 248 b and 248 c. Additionally, the arc of motion AOMinclude alternative shapes than depicted, such as but not limited toexemplary arcs of motion #2, #3 and #4 denoted by AOM2, AOM3 and AOM4,respectively. Accordingly, the radius r of each arc of motion AOM isdifferent. Certain arcs of motion AOM may be shaped such that the radiusr of different portions thereof are different, change, or vary.

In some circumstances, the joint 326 is sized, shaped and configured tomove the attached hip-thigh pad 286 so as to follow an alternative arcof motion AOM, such as by including at least one of an alternativelylocated virtual pivot point 248, an alternative length radius r, or analternatively shaped arc of motion AOM. For example, the prone patientsupport structure 15 may include joints 326 adapted for use with apediatric patient, a very tall patient, or a patient with certain spinalanomalies. In some embodiments, the patient positioning support system 5is provided with at least two prone patient support structures 15,wherein a first of the prone patient support structures 15 includes“standard” joints 326 that are useable with most patients, and a secondof the prone patient support structures 15 includes non-standard oralternatively configures joints 326 for use with pediatric patients,very tall patients, patients with certain spinal anomalies, and thelike. In some embodiments, the prone patient support structure 15includes modular joints 326 that are interchangeable to provide theability to use a single prone patient support structure 15 with adultand pediatric patients, short, medium and tall patients, and the like.

The joints 326 are movable between a first position and a secondposition with respect to the virtual pivot point 248, the arc of motionAOM and the floor F. The first and second positions are selected by anoperator, so as to move the patient's hips between a flexed position, anextended position and a “neutral” position wherein the hips are neitherflexed nor extended. For example, in FIG. 70, the first and second jointcomponents 328 and 330 are located and oriented so as to position apatient's hips in a neutral position. In another example, in FIG. 71,the first and second joint components 328 and 330 are located andoriented so as to position a patient's hips in an extended position. Inyet another example, in FIG. 72, the first and second joint components328 and 330 are located and oriented so as to position a patient's hipsin a flexed position.

It is noted that the first joint component 328 may be moved with respectto the second joint component 330, so as to be moved from theorientation or configuration shown in FIG. 70 to the orientation shownin FIG. 71, wherein such movement or motion is indicated by arrow 334.Similarly, the first joint component 328 may be moved with respect tothe second joint component 330, so as to be moved from the orientationshown in FIG. 70 to the orientation shown in FIG. 72, wherein suchmovement or motion is indicated by arrow 336.

The first joint component 328 includes maximum positions, with respectto the second joint component 330 wherein the patient's hips aremaximally flexed and maximally extended. The maximum positions areselected so as to cooperate with the patient's biomechanics, such thatthe patient's spine and additionally or alternatively hips can be flexedand extended a maximum amount. These maximum amounts of flexion andselections are selected so as not to injure the patient, but also toprovide a desirable amount of lordosis for a given spinal surgery, suchas is known in the art.

In some embodiments, the virtual pivot point 248 is located within apatient supported on the prone patient support structure 15. Forexample, the joints 326 may be sized, shaped and configured to align thevirtual pivot points 282 within the patient, such as near the lumbarspine or on or near the pelvis. Accordingly, in this embodiment, thefirst pitch axis P1 passes through the patient. For example, in someembodiments, the virtual pivot points 282 are located adjacent to thespine of a patient supported on the patient positioning support system5.

In some embodiments, the virtual pivot point 248 is located at a contactpoint between a patient supported on the prone patient support structure15 and a hip-thigh pad 286. For example, the virtual pivot point 248 maybe located where the patient's skin contacts the surface of thehip-thigh pad 286. Since the hip-thigh pads 286 are moldable orcompressible, the weight of the patient can cause the hip-thigh pads tobe compressed, thereby effectively moving the virtual pivot points 282above the hip-thigh pads 286 and into the patient's body, in someembodiments. Further, since the patient's belly hangs downward betweenthe hip-thigh pads 286, a virtual pivot point 248 located at a contactpoint between the patient's skin and a surface of the hip-thigh pad 286is associated with a first pitch axis P1 that passes through thepatient's body.

As discussed above, and with reference to FIGS. 73-84, the hip-thighpads 286 are joined with the associated joints 326. In particular, thehip-thigh pads 286 are attached to pad mounts 338 of the first jointcomponents 328. It is noted that when the joint is assembled with theframe 296, the pad attachment surfaces 340, of the pad mounts 338, facegenerally toward, or are oriented toward, the roll axis R, also referredto as being oriented in an inwardly or central direction. The padattachment surfaces 340 are attached to the undersides 342 of the pads286. The hip pad undersides 342 are contoured so as to not obstructmovement of the joins 326 or to bang into the frame 296, which coulddisrupt operation of the joints 326.

The virtual pivot point 248 includes a height or distance, denoted byD1, above the floor F, such as is shown in FIGS. 4, 24, 32, 40, 56,65-67, 69. The height D1 is substantially constant during, orthroughout, movement of the joint 326 with respect to the virtual pivotpoint 248. In an exemplary embodiment, with reference to FIGS. 4 and 40,wherein the patient positioning support structure 5 is positioned suchthat the joints 326 are in a neutral position, such that a patient'ships and spine are neither flexed or extended, and the virtual pivotpoint 248 is spaced a distance D1 above the floor F. The operatoradjusts the patient positioning support system 5 such that the virtualpivot point 248 is located at a selected height D1 above the floor F,such as but not limited to 48-inches, for example. The selected heightD1 is a convenient and additionally or alternatively comfortable workingheight for the surgeon to perform the surgery. D1 can be other heights,such as but not limited to a height D1 between minimum and maximumdistances above the floor F, wherein the minimum and maximum distancesprovide a range of selectable infinitely adjustable heights D1. Theheight D1 is associated with the locations of the upper portions 35 ofthe vertical translation subassembly 20. Accordingly, the minimum andmaximum heights D1 are associated with the vertical translationsubassemblies 20 being closed and maximally outwardly telescoped,respectively.

Continuing with the exemplary embodiment above, when the joints 326 areactuated and moved from the neutral position of FIG. 4 to the positionshown in FIG. 40, wherein the hips and knees of the patient would beflexed, the height D1 of the virtual pivot point 248 remains unchanged,or stays 48-inches from the floor F. Similarly, if the joints 326 areactuated and moved from the neutral position of FIG. 4 to the positionshown in FIG. 56, wherein the hips and knees of the patient would beextended, the height D1 of the virtual pivot point 248 still remainssubstantially unchanged, or 48-inches from the floor F.

The patient positioning support structure 5 is also configured such thatthe patient's hips and knees can be kept in the neutral positiondescribed above, and also the patient's body can be positioned in eithera Trendeleburg position, such as is shown in FIG. 32, or a reverseTrendelenburg position, such as is shown in FIG. 24. When prone patientsupport structure 15 is moved to the Trendeleburg and reverseTrendeleburg positions, the height D1 remains unchanged, or 48-inchesfrom the floor F.

FIG. 65 depicts the prone patient support structure 15 including joints326 positioned so as to maximally extend the patient's hips and knees,and the virtual pivot points 282 are located a distance D1 above thefloor F. In comparison, FIG. 66 depicts the prone patient supportstructure 15 including joints 326 positioned so as to maintain thepatient's hips and knees in a neutral position, or not flexed orextended, and the virtual pivot points 282 are also located a distanceD1 above the floor F, wherein the distance D1 of FIG. 65 issubstantially equal to the distance D1 of FIG. 66. In a furthercomparison, FIG. 67 depicts the prone patient support structure 15including joints 326 positioned so as to maximally flex the patient'ships and knees, wherein the virtual pivot points 282 are also located adistance D1 above the floor F, and wherein the distance D1 of FIG. 67 issubstantially equal to the distances D1 of FIGS. 65 and 66. Thus, as thejoints 326 are actuated, they are movable between a plurality ofselectable positions, the plurality of selectable positions beingbetween and including the positions shown in FIGS. 70-72 and FIGS.65-67, without substantially changing the heights D1 of the virtualpivot points 282 of the joints 326.

As noted above, the height D1 of the virtual pivot point 248 isadjustable. The height D1 can be adjusted by actuating one or both ofthe vertical translation subassemblies 20, so as to move the upperportions 35 upwardly or downwardly with respect to the associatedvertical translation axis V1 and V2. Such vertical translation of theupper portions 35 causes vertical translation of the associatedconnection assembly 75, which in turn is connected with the head-end orfoot-end frame members 310 and 312, respectively. At least a portion ofeach the hip-thigh pad 286 glides along the associated arc of motionAOM, such as, for example, when the associated joint moves to andbetween the positions shown in FIGS. 70-72 and FIGS. 65-67.

The prone patient support structure 15 includes a lower extremitysupport structure 344. The lower extremity support structure 344 isadapted to support the legs of the patient on the prone patient supportstructure 15. The lower extremity support structure 344 is also adaptedto move the patient's legs between the neutral, flexed and extendedpositions, and to support the legs when the legs are in those positions.For example, in FIG. 39, the lower extremity support structure 344 isrotated downwardly by the joints 326, such that the hips would beflexed. In another example, in FIG. 55, the lower extremity supportstructure 344 is rotated upwardly by the joints 326, such that the hipswould be extended.

The lower extremity support structure 344 includes an upper leg supportportion or femoral support 346, and a lower leg support portion or lowerleg cradle 348 that are joined or pivotably connected by a pair of kneehinges 350, so as to be movable between a first position and a secondposition; and wherein when in the first position, the femoral support346 and the lower leg cradle 348 are in a neutral position; and when inthe second position, the femoral support 346 and the lower leg cradle348 are in a flexed position. In some embodiments, the lower leg cradle348 is non-incrementally adjustable with respect to the femoral support346 and between the neutral position and a maximally flexed position. Inother embodiments, the lower leg cradle 348 is continuously adjustablewith respect to the femoral support 346 and between the neutral positionand a maximally flexed position. Additionally, in some embodiments, thelower leg cradle 348 is incrementally adjustable with respect to thefemoral support 346. In other embodiments, the lower leg cradle 348 isnon-incrementally adjustable with respect to the femoral support 346.

The knee hinges 350, also referred to as lower leg hinges, are spacedfrom and opposed to one another, and also enable flexion and extensionof the patient's knees between the first and second positions. The kneehinges 350 may be active, or powered, or the knee hinges 350 may bepassive, or un-powered, such as but not limited to spring hinges. Theupper leg support portion 346 includes a pair of spaced opposed rails352 with a thigh support sling 354 suspended therebetween. In someembodiments, the thigh support sling 354 is adjustable, such that theheight of the thighs is adjustable. In some embodiments, the thighsupport sling 354 is removable, such as for cleaning, replacement andadditionally or alternatively adjustment. The thigh support sling 354,like other components of the patient positioning support structure, suchas but not limited to the frame 396, the hip-thigh pads 286, and thejoints 326 may be covered with a disposable, or washable, covering ordrape provided as part of a draping kit, such as is known in thesurgical arts. The draping kit may also include one or more pillowstructures, for filling the thigh support sling 354, so as to supportthe thighs in a more preferred orientation.

The spaced opposed rails 352 are fixedly joined with the joint firstcomponents 328, such as is shown in FIGS. 65-67. Accordingly, inaddition to glidingly moving the hip-thigh pads 286 with respect to thearc of motion AOM, the joints 326 also move, pivot or rotate the rails352, and therefore the lower extremity support structure 344, about thefirst pitch axis P1. Accordingly, as the joints 326 move, or areselectively moved, from a neutral position, such as is shown in FIG. 66,to the maximally extended position, and such as is shown in FIG. 65, thepatients hips become progressively more extended, until the maximumextended position is reached. The operator can adjust the amount of hipextension, by selecting an extended position of the joints 326. Further,as the joints 326 move, or are selectively moved, from the neutralposition, shown in FIG. 66, to the maximally flexed position, such as isshown in FIG. 67, the patients hips become progressively more flexed,until the maximum flexed position is reached. It is noted that, due tothe knee hinges 350, the knees are also flexed and extended togetherwith the flexion and extension of the hips. However, it is foreseen thatthe lower extremity support structure 344 may be configured without kneehinges 350, such that the knees do not flex or extend.

In the illustrated embodiment, the lower leg support portion 348 is aframe adapted for supporting the lower legs of the patient. The lowerleg support portion 348 may include one or more cross-pieces 356 adaptedfor holding pillows or for attachment of the patient's lower legsthereto. Further, in some embodiments, the lower leg support portion 348includes one or more guide members 358 adapted to guide movement of thelower leg support portion 348 and additionally or alternativelyactuation of passive knee hinges 350. In some embodiments, such guidemembers 358 contact and slide along a guide track 360 of the foot-endportions of the frame 296, or the foot ends 304 of the left-hand andright-hand frame portions 306, 308, such as is shown in FIGS. 44-54. Itis foreseen that in some embodiments the frame 296 does not includeguide tracks 360. In some embodiments, the knee hinges 350 are activelydriven, or powered, such that the knee hinges 350 operate without theneed to guide tracks 360 or guide members 358.

In some embodiments, the lower extremity support structure 344 is joinedwith the joints 326 such that the lower extremity support structure 344is movable with respect to the virtual pivot point 248 and between thefirst and second positions, such as described above.

Torso Support Structure

The patient positioning support structure 5 of the present inventionincludes a torso support structure 362 that is received on andattachable to a head-end portion 302 of the frame 296 of the pronepatient support structure 15, so as to support the head and torso of apatient thereon. As shown in FIG. 12, the torso support structure 362includes a support body 364 with a substantially transparent face shield366, a chest pad 368 attached to the support body 364 and a plurality oflockable brackets 370 that are adapted for releasable connection to theframe 296. A pair of adjustable arm support boards 372, such as areknown in the art, is attachable either to the support body 364 oroptionally to the frame 296 of the patient support structure 15. Aring-shaped pillow or similar structure (not shown) may be placed on theface shield 366 so as to support the patient's head while simultaneouslyproviding clearance for anesthesia tubing or other equipment. The chestpad 368 is somewhat compressible and substantially radiolucent. In someembodiments, the chest pad 368 includes two or more chest pads 368. Thechest pad 368 may be covered with a cover or drape, such as is describedelsewhere herein. The position of the chest pad 368 is slidablyadjustable along a length of the head-end portion 302 of the frame 296.Accordingly, the torso support structure 362 can be slid or moved alongthe frame head-end portions 302, or along a length thereof, so as toposition the chest pad 368 in a suitable location with respect to thepatient's body and biomechanics. Once the chest pad 368 is in a suitableposition along the frame 296, the torso support structure 362 can belocked into place on the frame 296, such as by actuating reversiblylockable brackets 370.

Referring to FIGS. 162-165, when the patient positioning support system5 is being assembled for a sandwich-and-roll procedure, the patient isface up on the supine support structure 15′, described below, and theprone patient support structure 15 is positioned over or on top of thepatient, such that the patient is sandwiched between the two structures15 and 15′. Then, the torso support structure 362 is placed onto theframe 296, such that the chest pad 368 is located between the sides ofthe frame 296, or between the left-hand and right-hand frame portions306, 308, and against the patient's chest. The location of the chest pad368 is adjusted by sliding it along the length of the frame 296 upperportion 302. When the desired location of the chest pad 368 is reached,achieved or selected, the brackets 370 are locked or otherwise engagedso as to fix the position of the torso support structure 362 withrespect to the frame 296. The patient's arms are positioned andremovably attached or strapped onto adjustable arm boards 372 of thetorso support structure 362, and then the sandwiched patient can berolled over about the roll axis R.

Referring to FIGS. 65-68, the hip-thigh pads 286 are associated with alower-body side of the joints 326 and the chest pad 368 is associatedwith an upper-body side of the joints 326. Accordingly, the hip-thighpads 286 are opposed to and spaced a distance from the chest pad 368. Inparticular, the virtual pivot point 248 of each hip-thigh pad 286, or ofeach joint 326, is spaced a distance D2 from the chest pad 368. As shownin FIG. 68, as the hip-thigh pads 286 are rotated about the pivot point248, the distance D2 between the pivot point 248 and the chest pad 368is substantially constant. Additionally, when the joints 326 are movedto an extended or flexed position, even though the distance D2 betweenthe pivot point 248 and the chest pad 368 remains substantiallyconstant, the hip pads 286 may translate laterally, or horizontally, adistance D3 toward the head-end of the patient positioning supportsystem 5. Generally, the distance D3 is relatively small. When thejoints 326 return to the neutral position, the hip pads 286 move back tothe starting position, such as by laterally or horizontally translatinga distance D3 toward the foot-end of the system 5 such as toward thefoot end 16′ of the base 10 or toward the foot end 19 of the pronepatient support structure 15.

Accordingly, in some embodiments, the distance D2 between the chest pad368 and the hip-thigh pads 286 is substantially constant during movementof the joints 326 between a first position and a second position, ortoward and away from the head-end 16 of the base 10 when moving betweenneutral and angulated positions. In other embodiments, the distance D2between the chest pad 368 and the hip-thigh pads 286 is slightlyvariable during movement of the joints 326.

Supine Patient Support Structure

In some embodiments, the present invention includes a supine patientsupport structure 15′ that is suspended above the floor F, such as isillustrated in FIGS. 102-120. In particular, the patient positioningsupport structure 5 of the present invention includes a base 10 thatsupports or suspends the supine patient support structure 15′ above thefloor F. The supine patient support structure 15′ is removablyattachable to the base 10 using a pair of ladders 100, 100′, such aswith a pair of standard-length ladders 100 or a pair of extended-lengthladders 100′, such as is described above with respect to attaching theprone patient support structure 15 to the base 10 using a pair ofstandard-length ladders 100.

In some embodiments, the supine patient support structure 15′ includesan open frame 374 that is articulatable or breakable at a pair of spacedopposed hinges 376, and at least one of a set of body support pads (notshown), such as is known in the art, and a closed table-top 378. Thesupine patient support structure 15′ also includes head- and foot-ends288′, 290′, and left-hand and right-hand sides 298′, 300′. The closedtable-top 378 includes a head portion 380 and a foot portion 382, andmay be covered by one or more flat pads 384. In some embodiments, thebody support pads, the elongate table pad 384 and the table-top 378 aresubstantially radiolucent.

The supine patient support structure 15′ includes head-end and foot-endladder connection subassemblies 190′. In some embodiments, the ladderconnection subassemblies 190′ are configured and arranged so as to besubstantially the same in structure and function as the ladderconnection subassemblies 190 of the prone patient support structure 15.In other embodiments, other ladder connection subassemblies 190′ areused. The ladder subassemblies 190′ are attached to either a pair ofstandard length ladders 100 or a pair of extended length ladders 100′using a pair of T-pins 101, such as is described with respect to theladder connection subassemblies 190 of the prone patient positioningstructure 15. It is noted that the T-pins 101 are coaxial with secondand third pitch axes P2 and P3 of the supine patient support structure15′, similar to that described above with respect to the prone patientsupport structure 15, whereby the supine patient support structure 15′can rotate or pivot about the second and third pitch axes P2 and P3.

The spaced opposed hinges 376 of the supine patient support structure15′ include a first pivot axis P1. As shown in FIGS. 116-120, each hinge376 includes first and second hinge members 388 and 390, respectively,and a worm drive, generally 392. A shroud or housing 394 covers andprotects the worm drive 392. The worm drive 392 is also partiallycovered by a frame portion 396 that joins the second hinge member 390with the frame 374 of the supine patient support structure 15′. In someembodiments, the frame 374 includes one or more of the first and secondhinge members 388, 390, and the frame portion 396. However, it isforeseen that the hinges 376 may be entirely separate from but connectedto the frame 374.

The worm drive 392 is a gear arrangement in which a worm 398, which is agear in the form of a screw, meshes with a worm gear 400. Like othergear arrangements, a worm drive 392 can reduce rotational speed or allowhigher torque to be transmitted. In the illustrated embodiments, theworm drive 392 is actuated by a motor 402 and the amount of pivot aboutthe first pitch axis P1 is selectable.

In some embodiments, the supine patient support structure 15′ isreversibly positionable in a decubitus position, such as is shown inFIGS. 112-113. In a decubitus position, the patient may be positioned ontheir side, such that the patient is bent at the waist, with the headand feet lower than the hips. A lateral-decubitus position is essentialfor certain spinal surgeries, such as is known in the art. When in adecubitus position, the supine patient support structure 15′ is joinedwith the base 10 using the extended-length ladders 100′. Theextended-length ladders 100′ are useful for positioning the patient in alater-decubitus position while spacing the surgical site, and thereforethe first pitch axis P1 and the hinges 376, a suitable distance D4 fromthe floor F, such that the surgeon can perform the surgery comfortably.

In some embodiments, the patient positioning support system 5 includes asupine patient support structure 15′, such as is shown in FIGS. 102-108,that is used for positioning a patient (not shown) in a supine orlateral position, such as is described elsewhere herein.

In another exemplary embodiment of the supine patient support structure15′ shown in FIG. 105, a first pitch axis P1 is associated with the pairof spaced opposed hinges 376. The supine patient support structure 15′also includes second and third pitch axes P2 and P3 that are associatedwith its head and foot-ends, which are generally denoted by the numerals18′ and 19′ respectively.

For convenience, the left and right-hand sides of the supine patientsupport structure 15′ are designated 298′ and 300′, and are alsoassociated with the left and right sides, respectively of the patient.Accordingly, when the table is configured for a sandwich-and-rollprocedure, the two left-hand sides 298 and 298′ of the prone and supinepatient support structures 15 and 15′ are spaced and opposed from eachother, on the front and back sides of the patient, such as is shown inFIGS. 92a and 94b -99. Additionally, the two right-hand sides 300 and300′ of the prone and supine patient support structures 15 and 15′ arealso spaced and opposed from each other, on the front and back sides ofthe patient.

With reference to FIGS. 112 and 114, the vertical translationsubassemblies 20 can be raised or upwardly telescoped, such as to raisethe ends 18′ 19′ of the supine patient support structure 15′. Whilemoving to the position shown in FIG. 114, the height of the surgicalsite D4 is maintainable by pivoting the hinges 376 downwardly.

Still revering to FIGS. 112 and 113, in some embodiments, the supinepatient support structure 15′ includes an in-frame translationcompensation subassembly 320′ that is substantially similar to thetranslation compensation subassembly 320 of the prone patient supportstructure 15. The in-frame translation compensation subassembly 320′includes a translation bar 322′, which is most easily seen in FIG. 112,that is actively extended and retracted, or telescoped at the foot-end304′ of the frame 374. It is foreseen that in some embodiments thesupine patient support structure 15′ includes a translation compensationsubassembly 320′ that is located outside of the frame 374. It isforeseen that in some embodiments, the supine patient support structure15′ includes a translation compensation subassembly 320′ such as but notlimited to translation compensation structures and mechanisms describedin U.S. Pat. Nos. 7,152,261, 7,343,635, 7,565,708, 8,060,960, or U.S.Patent Application No. 60/798,288, U.S. patent application Ser. No.12/803,173, U.S. patent application Ser. No. 12/803,192, or U.S. patentapplication Ser. No. 13/317,012.

Sandwich-And-Roll Procedure

In some embodiments, such as but not limited to when performing varioussteps of a sandwich-and-roll procedure, such as is illustrated in FIGS.85-101 and 134-169, the supine patient support structure 15′ is spacedfrom and opposed to the frame 296 of the prone patient support structure15. In these embodiments, both the prone and supine patient supportstructures 15 and 15′ are attached to the base 10. When both the proneand supine patient support structures 15 and 15′ are attached to thebase 10, a patient can be reversibly sandwiched between the structures15 and 15′. The space S between the prone and supine patient supportstructures 15 and 15′ is adjustable. For example, in some embodiments,the space S can be modified by moving one of the patient supportstructures 15 or 15′ away from, or toward, the opposed patient supportstructure. For example, a first T-pin 101 associated with a first end ofthe patient support structure 15 or 15′ to be adjusted can bedisconnected, such as described elsewhere herein, followed by moving theassociated end of the patient support structure upwardly or downwardly adistance, and reconnecting the first T-pin 101; followed bydisconnecting a second T-pin 101 associated with the second end of thepatient support structure 15 or 15′, adjusting the second end of thepatient support structure the same distance as the first end, and thenreconnecting the second T-pin 101.

Referring now to FIGS. 4-7, and as noted above, the patient positioningsupport structure 5 of the present invention includes a base 10 with apair of spaced opposed vertical translation subassemblies 20 that areoptionally joined by a cross-bar 25. The patient positioning supportstructure 5 is adapted such that the vertical translation subassemblies20 are not substantially laterally movable with respect to one anotherduring operation of the patient positioning support structure 5. Thepatient positioning support structure 5 also includes a prone patientsupport structure 15 removably attached to the base 10 by connectionsubassemblies 75 located at the head- and foot-ends 18, 19 of the pronepatient support structure 15. The patient positioning support structure15 includes a pair of spaced opposed gliding or sliding joints 326. Thejoints 326 each include a virtual pivot point 248, and arc of motion AOMand a radius r. The joints 326 are attached to hip-thigh pads 286 andare sized, shaped, configured and arranged to slidingly rotate at leasta portion of the hip-thigh pads 286 about or around the virtual pivotpoint 248 and along the arc of motion AOM. Accordingly, the hips of apatient on the prone patient support structure 15 can be flexed andextended about the virtual pivot point 248, thereby enabling flexion andtranslation of the hips substantially without lateral translation of thepatient's torso. The virtual pivot point 248 is associated with aselectable location or height for the surgical site, wherein the heightof virtual pivot point 248 is spaced a first distance D1 above the floorF. As the prone patient support structure 15 is manipulated to place thepatient in various positions, such as but not limited to flexed orarticulated positions and additionally or alternatively Trendelenburg orreverse Trendelenburg positions, the patient positioning supportstructure 5 is adapted to substantially maintain the first distance D1.

Still referring to FIGS. 4-7, the patient positioning support system 5includes a roll axis R, about which the prone patient support structure15 can be tilted or rotated. When the supine patient support structure15′ is attached to the base 10, the supine patient support structure 15′can also be tilted or rotated about the roll axis R. The patientpositioning support system 5 includes a pair of vertical translationaxes V1 and V2, wherein each of the vertical translation axes V1 and V2is associated with one of the vertical translation subassemblies 20.Additionally, the patient positioning support system 5 includes a pairof yaw axes Y1 and Y2 associated with the connection subassemblies 75.The yaw axes Y1 and Y2 allow for generally small amounts of rotation ofthe patient support structure 15 or 15′ when the patient supportstructure 15 or 15′ is placed in a Trendelenburg or reverseTrendelenburg position and also tilted about the roll axis R.

The prone patient support structure 15 includes a releasably attachableand lockable torso support structure 362 with a chest pad 368. Thelocation of the chest pad 368 is slidably adjustable along a length ofthe prone patient support structure 15, as indicated by the straightdouble-headed arrow above the torso support 580 that is generallyparallel with the roll axis R.

As shown in FIGS. 23-30, the patient positioning support system 5 isconfigured and arranged to move and place the patient support structure15 or 15′ in a reverse Trendelenburg position, such as but not limitedto by outwardly telescoping the head-end vertical translationsubassembly 20 and alternatively or additionally inwardly telescopingthe foot-end vertical translation subassembly 20, such as is indicatedby the upward and downward arrows, respectively. It is noted that D1 inFIG. 24 is substantially equal to D1 in FIG. 4. In FIG. 4, the roll axisR is substantially parallel with the floor F. However, in FIG. 24, theroll axis R sloped upwardly from the floor F, moving from left to rightacross the page. It is noted that when the patient support structure 15is moved from the position of FIG. 4 to the position shown in FIG. 24,the distance between the virtual pivot point 248 and a point of thechest pad 368 does not change substantially. Also, in the configurationof FIG. 24, the patient support structure 15 had not substantiallypivoted about either of the yaw axes Y1 or Y2. In the position shown inFIG. 24, the patient support structure 15 does pivot about the secondand third pivot axes P2 and P3, which is most easily in FIGS. 24, 29 and30, and is indicated by arrows 292 and 294.

FIGS. 31-38 show the patient positioning support structure in aTrendelenburg position. This positioning is achieved by telescoping thevertical translation subassemblies 20 in opposite directions from thoseassociated with placing the patient positioning support structure in areverse Trendelenburg position. It is noted that D1 of FIG. 32 issubstantially equal to D1 of FIGS. 4 and 24.

FIGS. 39-47 illustrate the configuration of the patient positioningsupport structure 5 with the patient support structure 15 in a neutralposition and the joints rotated such that the lower extremity supportstructure 344, or lower body support structure, is adjusted so as toflex the hips and knees of a patient thereon. Again, D1 of FIG. 40 issubstantially equal to D1 of FIGS. 4, 24 and 32.

FIGS. 48-53 illustrate the patient positioning support structure 5 withthe patient support structure 15 in a neutral position and the jointsrotated such that the lower body support structure 344 is adjusted so asto flex the hips and knees of a patient thereon and also such that thepatient support structure 15 is rolled or tilted about, orapproximately, 25-degrees about, or around, the roll axis R. Suchtilting can proved improved access to the surgical site. The patientsupport structure 15 can also be tilted when the legs are extended, suchas is described elsewhere herein.

FIGS. 55-64 illustrate the patient positioning support structure 5 withthe joints 326 rotated such that the lower body support structure 344 isadjusted so as to extend the hips and knees of a patient thereon. It isnoted that the distance D1 of FIG. 56 is substantially equal to thedistance D1 of FIGS. 4, 24, 32 and 40. To maintain the height D1 whileextending the hips, the head-end vertical translator 20 is telescopedupwardly, so as to raise the head-end 18 of the patient supportstructure 15, and the foot-end vertical translator 20 is telescopeddownwardly, so as to lower the foot-end 19 of the patient supportstructure 15. This changes the roll axis R to a position slopingupwardly, when viewed from the left to the right of the page.Additionally, articulation or rotation occurs about all three pitchaxes, P1, P2 and P3.

Methods of Positioning a Patient on the Patient Positioning SupportSystem

The present invention also provides a method of positioning a patient ona patient positioning support system 5 in a prone position, varioussteps of which are shown in FIGS. 134-169. In one embodiment the methodincludes a first step of placing a patient on a supine patient support15′ suspended above a floor F by a base structure 10, such that thepatient is in a substantially supine position. In a second step, such asis shown in FIGS. 134-139 and 160-169, the patient is sandwiched betweenthe supine patient support 15′ and a prone patient support 15 suspendedabove the supine patient support 15′. Then, the patient is rolled anamount of about 180-degrees with respect to a longitudinally extendingroll axis R, such that the patient is in a substantially prone position,such as to but not limited to as is shown in the sequence of FIGS. 134through 136. After the patient has been transferred to the prone patientsupport structure 15, the supine patient support 15′ is removable.

To roll the patient over, from the position shown in FIG. 134 to theposition shown in FIG. 136, the motor or actuation system of the patientpositioning support system 5 is disconnected or temporarily inactivated,such as but not limited to by disengaging a clutch, such as is known inthe art, and such that a group of personnel can manually roll thepatient over. After the patient had been rolled over, the clutch isre-engaged, such that the patient support structure 15 can be furtherpositioned for the surgical procedure that is to be performed.

To return the patient to a supine position, the steps of the method areperformed in reverse as was described above. Accordingly, the patient isagain sandwiched between the prone and supine patient support structures15 and 15′, and rolled back over to a supine position on the supinepatient support structure 15′. When the patient is on the supine patientsupport structure 15′ the patient can be transferred to a gurney orother mobile support structure, or repositioned on the supine patientsupport structure 15′ for a lateral-decubitus surgical procedure.

In a further embodiment, the step of sandwiching the patient between thesupine patient support 15′ and the prone patient support 15 includesattaching the prone patient support 15 to a pair of spaced opposedconnection subassemblies 75, such as by ladders 100 attached to rotationsubassemblies 50 associated with the base head-end 16 and foot-end 16′.

FIGS. 170-178 illustrate another embodiment 900 of a breaking supinelateral patient support 15′ in another embodiment. As shown in FIG. 170,the patient support 900 includes head-end and foot-end portions 905 and910 for supporting and positioning a patient in a supine position, suchas described herein. The head-end portion 905 includes a frame portion915 and a solid planar top structure, member or portion 920, or tabletop, non-removably attached thereto, as well as left and right sideaccessory attachment members 925. The foot-end portion 910 also includesa frame portion 930 and a solid planar top structure, member or portion935, or table top, non-removably attached thereto, as well as left andright side accessory attachment members 940. The head end portion 905 isjoined with the foot-end portion 910 by a pair of spaced apart opposedhinges, generally 376, such as are described herein. At each of itsoutboard ends 950, the patient support 900 includes an attachmentstructure for attachment to a ladder 100 or 100′, such as is describedelsewhere herein. At the foot outboard end 950, the foot-end frameportion 930 includes an in-line or in-frame, longitudinal translationcompensation subassembly, generally 955, that is substantially similarto the translation compensation subassembly 320 described elsewhereherein.

The patient support 900 is adapted to support the patient both supine orlateral positions. The patient support 900 includes a pair of spaceopposed hinges 376, such as is described elsewhere herein. The patientsupport 900 operates, angulates, breaks or articulates from 0° to about40° hinge apex in an upward direction. The patient support 900 so as tosupport the patient when the hinges operate, angulate, break orarticulate from 0° to 30° hinge apex in a downward direction. Thepatient support 900 includes attachment rails 925, 940 for ClarkSockets. The patient support 900 is adapted to function with a patientweight of up to 600-pounds. Additionally, the patient support 900provides for translation compensation during hinge apex up and downpositioning, such as by an in-frame translation compensation subassembly320, such as is described elsewhere herein. Further, the patient support900 includes attachment points for attachment to the base structure 10,such as is described above or as described herein.

FIGS. 179-187 illustrate a non-breaking or fixed frame patient support1000, for supporting a patient in a non-angulated supine, prone orlateral positions. The patient support 1000 includes head-end andfoot-end support portions 1005 and 1010. The patient support 1000 alsoincludes a frame portion 1015 and a removably attached solid planar topstructure, member or portion 1019, or table top. Reversibly engageableclamps 1020 removably or releasably attach the top structure 1019 to theframe portion 1015. The frame portion 1015 includes a pair of spacedspars 1021 joined at the respective head and foot ends 1022 and 1023,respectively, by head- and foot-end frame cross-members 1024 and 1025,respectively. As shown in FIG. 181, the foot-end frame cross-member 1025is longer than the head-end cross-member 1024. Accordingly, the frameportion of the foot-end portion 1010 is wider than the frame portion1015 of the head-end portion 1005. Each of the spars 1021 includes atransition portion 1026 that is contoured so as to curve, bend or bowoutwardly when moving along a length of each of the spars 1021, such asalong a central portion thereof, when moving along the spar 1021 in adirection from the head end toward the foot end thereof, as indicated bythe directional arrow 1027. It is noted that the frame portion 1015 isnon-breaking as it includes no hinges.

Each of the left-hand and right-hand sides of the frame portion 1015, ofthe head-end support portion 1005, includes at least one accessoryattachment member 1030, for attachment of accessories for supportinglimbs of the patient, such as is known in the art.

At each of its outboard ends 1050, the patient support 1000 includes anattachment structure 1053 for reversible attachment to a ladder 100 or100′, such as is described elsewhere herein. It is foreseen that theladders 100 or 100′ may be integral, and therefore non-removable, withthe attachment structures 1053 at one or both of the outboard ends 1050.Alternatively, the attachment structure 1053 may be configuredsubstantially similarly to the attachment structure 314, 316 describedabove. It is foreseen that in other patient supports described herein,the ladder and the attachment structure may also be integral ornon-detachable. At the foot outboard end 1050, the frame portion 1015includes an in-line or in-frame, longitudinal translation compensationsubassembly, generally 1055, that is substantially similar to thetranslation compensation subassembly 320 described elsewhere herein.

The patient support 1000 is adapted to function or operate with apatient weight up to about 600-pounds. Removable flat tops 1019 areincorporated into the patient support 1000. The patient support 1000 isadapted to provide for supine patient positioning and for prone patientpositioning. The patient support 1000 is adapted for attachment of anadjustable chest support structure. The patient support 1000 is adaptedfor attachment of adjustable pelvic support structures, such as areknown in the art. The patient support 1000 is adapted for attachment ofadjustable leg supports, such as are known in the art. The flat tops1019 include rails 1030 for Clark Socket attachments. The patientsupport 1000 includes attachment points for attachment to the basestructure 10, such as at the outboard ends 1050.

FIGS. 188-196 illustrate yet another embodiment 1100 of a breakingsupine lateral patient support 15′ in another embodiment. As shown inFIG. 188, the patient support 1100 includes head-end and foot-endportions 1105 and 1110 for supporting and positioning a patient in asupine position, such as described herein. The head-end portion 1105includes a frame portion 1115 and a solid planar top structure, memberor portion 1120, or table top, removably attached thereto by reversiblyactuatable clamps 1121, as well as left and right side accessoryattachment members 1125. The foot-end portion 1110 also includes a frameportion 1130 and a solid planar top structure, member or portion 1135,or table top, removably attached thereto by additional reversiblyactuatable clamps 1121, as well as left and right side accessoryattachment members 1140. It is noted that in this embodiment, the topstructures 1120 and 1135 rest or are attached on top of the respectiveframe portions 1115 and 1130, and are substantially wider than therespective frame portions 1115 and 1130, such that the hinges are atleast partially covered by the frame portions 1115 and 1130. It isforeseen that the top structures 1120 and 1135 may be wider than isshown, so as to support larger than average patients.

The head end portion 1105 is joined with the foot-end portion 1110 by apair of spaced apart opposed hinges, generally 1145, such as aredescribed herein. At each of its outboard ends 1150, the patient support1100 includes an attachment structure for attachment to a ladder 100 or100′, such as is described elsewhere herein. At the foot outboard end1150, the foot-end frame portion 1130 includes an in-line or in-frame,longitudinal translation compensation subassembly, generally 1155, thatis substantially similar to the translation compensation subassembly 305described elsewhere herein.

FIGS. 197-205 illustrate another embodiment of a prone patient support1200 that is substantially similar to the prone patient support 15described above. Accordingly, this prone patient support 1200 isnumbered the same way as the first prone patient support 15. In thisembodiment, the phone patient support 1200 includes modified joints 326,or hinges, and hip-thigh pads 286. In particular, the joints 326 includea motor subassembly 1205 that is moved to an outer side 1210 of theframe 296. This contrasts with the motor subassemblies 333 of the firstprone patient support 15, most easily seen in FIGS. 75 and 78, whereineach motor subassembly 333 is located on the inner side of the joints326 or the frame 296, so as to be located under the respective hip-thighpads 286. With respect to the hip-thigh pads 286, in addition to beingcontoured to fit the patient's pelvic region closely while allowing thepatient's belly to depend between the joints 326, as is the case withthe first prone patient support 15, each hip-thigh pad 286 includes asmall forward hip pad 286 a. The forward hip pad 286 a providesadditional support to the patient's pelvis and protects the patient fromthe forward end of the joint subassembly. Additionally, the hip-thighpads 286 and the forward hip pads 286 a comprise a patient pelvissupport assembly that is adapted to position or extend the patient'spelvis at an angle from between about 0° and about 25° under power.Patient chest or torso support 362 is manually adjustable along a lengthof the frame 296, such as is described elsewhere herein. As describedherein, the chest support 362 is manually lockable in place along alength of the frame head-end portion 302, so as to substantially preventmovement along an axis parallel to the patient's centerline, or withrespect to the roll axis R. The prone patient support 15 or 1200 isconstructed of resilient and strong materials such that a patientweighing up to 600-pound can be safely supported, positioned for asurgical procedure and rolled between prone and supine positions, suchas is described above. It is noted that the foot-end portion of theframe 296 is wider than the head-end portion of the frame 296, so as toaccommodate the lower extremity support structure 344 between the spars310, 312 thereof.

The prone patient support 1200 includes attachment subassemblies 314,316 for attachment to the base structure 10, such as is describe abovewith respect to the prone patient support 15.

The prone patient support 1200 provides for attachment of an adjustablechest support structure 362, such as is described above.

The patient's lower limbs are supported in a fixed position relative tothe patient's pelvis, such as is described above. The prone patientsupport 1200 provides support to shins and feet during both flexion andextension of patient's hips, such as is described above with respect tothe first prone patient support 15. Further, the prone patient support1200 allows the patient pelvis to rotate about a fixed, virtual axisduring flexion and extension, such as pivot axis P1.

FIGS. 206-239 illustrate another patient positioning and support system,generally 5, for supporting and positioning a patient for a surgicalprocedure, including an off-set base 1310 and a patient supportstructure 15 ⁰. In particular, the off-set base 1310 is sized, shaped,configured and adapted for suspending none, one or both of a pronepatient support structure 15 and a supine patient support structure 15′above the floor F at a convenient position and orientation for a medicalprocedure. It is noted that the off-set base 1310 is similar to the base10, the description of which is incorporated herein by reference.

The off-set base 1310 includes head and foot-ends 16, 16′, left andright-hand sides, and top and bottom sides, which for discussionpurposes are denoted relative to the sides of a patient's body when thepatient is positioned in a prone position on the prone patient supportstructure 15. The base 1310 also includes a plurality of axes, includingbut not limited to a roll axis R, a pitch axis P_(E), and two verticaltranslation axes V1° and V2°, which are most easily seen in FIGS. 206,207, 212-219, 228 and 230, and are discussed in greater detail below.The patient support structures 15 and 15′ each include head and footends 18, 18′ and 19, 19′, respectively, and first, second and thirdpitch axes which are denoted by P1, P2 and P3 respectively.

FIG. 206 is a perspective view of an off-set base 1310 of the presentinvention, in an exemplary embodiment. The off-set base 1310 may also bereferred to as a base structure or base subassembly. The base 1310 isadapted to support the patient support structure 15 ⁰ above the floor F.The base 1310 includes structure that is adapted to lift and lower,tilt, roll, rotate and, additionally or alternatively, angulate at leasta portion of the patient support structure 15 ⁰ relative to the floor F,so as to position a patient's body in a desired position for a medicalprocedure, such as is described in greater detail below. In variousembodiments, the movements of the patient positioning support system 5,with respect to the head and foot-ends, left and right-hand sides, andtop and bottom sides, as well as with respect to the axes can be one ormore of synchronous or sequential, active or passive, powered ornon-powered, mechanically linked or synchronized by software, andcontinuous, such as but not limited to within a range, or incremental,and such as is described in greater detail below.

The base 1310 includes a pair of spaced opposed vertical translationsubassemblies 20, also referred to as vertical elevator assemblies,telescoping piers, vertical translators, or the like. In the illustratedembodiment, the vertical translation subassemblies 20 are generallyidentical and face one another, though it is foreseen that the base 1310may include only a single vertical translation subassembly 20 and thatone or both vertical translation subassemblies 20 may have analternative structure. For example, one of the vertical translationsubassemblies 20 may be constructed such as described in U.S. Pat. Nos.7,152,261, 7,343,635, 7,565,708, 8,060,960, or U.S. Patent ApplicationNo. 60/798,288, U.S. patent application Ser. No. 12/803,173, U.S. patentapplication Ser. No. 12/803,192, or U.S. patent application Ser. No.13/317,012, all of which are incorporated by reference herein in theirentireties.

In the illustrated embodiment, the cross-bar 25 is a substantially rigidsupport that joins and holds the vertical translation subassemblies 20in spaced opposed relation to one another. In a further embodiment, thecross-bar 25 is non-adjustable. However, in some other embodiments, thecross-bar 25 is removable or telescoping, so that the verticaltranslation subassemblies 20 can be moved closer together, such as forstorage. In certain embodiments, the cross-bar 25 is longitudinallyadjustable so that the vertical translation subassemblies 20 can bemoved closer together or farther apart, such as, for example, to supportor hold different patient support structures 15 ⁰ of various lengths orconfigurations, such as but not limited to interchangeable or modularpatient support structures 15 ⁰. In certain other embodiments, therepatient positioning support system 5 does not include a cross-bar 25.Numerous cross-bar 25 variations are foreseen.

Regardless of the presence or absence of any such cross-bar 25 describedherein or foreseen, the vertical translation subassemblies 20 aresubstantially laterally non-movable with respect to one another, eithercloser together or farther apart, once a patient support structure 15 ⁰has been attached to or joined with the base 1310, and during use of thepatient positioning support system 5.

Referring again to FIGS. 206, 212-219, a vertical translationsubassembly 20 of the present invention includes lower and upperportions, generally 30 and 35 respectively, a lower support structure40, such as a base portion or a foot, and an off-set elevatorsubassembly 1341 extending therefrom.

The off-set elevator subassembly 1341 extends upwardly from a first end1342 of the lower support structure 40 and includes at least a primaryelevator portion 1343 and optionally a secondary elevator portion 1344.The second end 1342′ of the lower support structure 40 extends from thefirst end 1342 so as to be parallel with the floor F and perpendicularto the roll axis R. The size of the second end 1342′, such as but notlimited to the length, width, height and weight of the second end 1342′,is sufficient to counterbalance the first end 1342 and an attachedpatient support 15 ⁰, so as to substantially prevent collapse of thepatient positioning and support system 5. Additionally, as shown in FIG.206, the off-set elevator subassemblies 1341 are spaced and opposed toone another so as to be located on opposite sides of the roll axis Rrelative to one another, so as to substantially prevent collapse of thepatient positioning and support system 5.

The primary elevator portion 1343 includes a primary verticaltranslation axis V1° and riser assembly 45 with a mechanical drivesystem or mechanism (not shown), such as is known in the art, that liftsand lowers the upper portion 35 along the primary vertical translationaxis V1° relative to the floor F. Movement of the primary elevatorportion 1343 is controlled by a computer (not shown) so as to besynchronized with movements of other portions or components of thepatient positioning and support system 5.

The secondary elevator portion 1344 includes a secondary verticaltranslation axis V2° and a mechanical drive system or mechanism (notshown), such as is known in the art that lifts and lowers an attachedrotation subassembly 50, described below, along the secondary verticaltranslation axis V2° relative to the floor F. Movement of the secondaryelevator portion 1344 is controlled by a computer (not shown) so as tobe synchronized with movements of other portions or components of thepatient positioning and support system 5.

It is noted that, since the primary elevator portion 1343 raises andlowers the secondary elevator portion 1344, the primary elevator portion1343 also raises and lowers the rotation subassembly 50. It is foreseenthat in some embodiments, there is no secondary elevator portion 1344and the primary elevator portion 1343 lifts and lowers the rotationsubassembly 50 directly.

In addition to rolling an attached patient support structure 15 ⁰ aboutthe roll axis R, such as is described above, the rotation subassembly 50of the base 1310 enables tilting of the patient support structure 15 ⁰about the pitch axis P_(E), such as is described below. Movement abouteach of the axes R and P_(E), is associated with a rotation motor.Accordingly, the rotation subassembly 50 includes first and secondmechanical rotation motors 55 and 55′ joined with first and secondrotation shafts 56 and 56′, respectively.

A first rotation motor subassembly includes the first motor and shaft55, 56, which are associated with the roll axis R and provide fortilting and rolling of an attached patient support structure 15 ⁰ aboutthe roll axis R. It is noted that the first shaft 56 is coaxial with theroll axis R.

A second rotation motor subassembly includes the second motor and shaft55′, 56′, which are associated with the pitch axis P_(E) and provide forangulating or articulating an attached patient support structure 15 ⁰about the pitch axis P_(E). It is noted that the second shaft 56′ iscoaxial with the pitch axis P_(E), perpendicular to the roll axis R andsubstantially parallel with the floor F. The second shaft 56′ isoperably joins the first shaft 56 with the secondary elevator portion1344, so as to rotate the first shaft 56 about the pitch axis P_(E),thereby moving the first shaft 56, and the associated roll axis R, to anorientation that is non-parallel with, or angulated with respect to, thefloor F. Accordingly, the roll axis R to can be moved from a firstposition or orientation that is substantially parallel with the floor F,such as is shown in FIG. 220, to a second portion or orientation that isnot substantially parallel with the floor F, such as is shown in FIGS.228 and 230, such as when the patient support structure 15 ⁰ is placedin a Trendelenburg or a reverse Trendelenburg position.

The motors 55, 55′ may be any motor known in the art that is strongenough to rotate the patient support structure 15 ⁰ with respect to theroll axis R and pitch axes P_(E), and optionally to lock the patientsupport structure 15 ⁰ in a tilted or angulated orientation with respectto the floor F. Harmonic motors are particularly useful as the rotationmotor due to their strength. Alternatively, the rotation subassembly 50may be constructed such as described in U.S. Pat. Nos. 7,152,261,7,343,635, 7,565,708, 8,060,960, or U.S. Patent Application No.60/798,288, U.S. patent application Ser. No. 12/803,173, U.S. patentapplication Ser. No. 12/803,192, or U.S. patent application Ser. No.13/317,012, all of which are incorporated by reference herein in theirentireties. Numerous variations are foreseen. Non-motorized rotationsubassemblies 50 are also foreseen.

The base 1310 includes a pair of connection subassemblies 57, forreversible attachment with a patient support structure 15 ⁰. Eachconnection subassembly 57 includes a rotation block 57, a ladder 100 anda T-pin 101. The rotation block 57, also referred to as a ladderconnection block 57, is reversibly attachable or connectable to at leastone ladder structure 100, which in turn is reversibly attachable to anend of the patient support structure 15 ⁰. The connection subassemblies57 provide structure for removably connecting, attaching or joining thebase 10 with a patient support structure 15 ⁰. In the illustratedembodiment, the head-end and foot-end rotation blocks 57 aresubstantially identical; however, it is foreseen that one or both of theblocks 57 may have an alternative size, shape and additional oralternative configuration.

The connection subassemblies 57 provide structure for at least somevertical translation, or height adjustment, of an attached patientsupport structure 15 ⁰. Further, the two connection subassemblies 57cooperate with each other and optionally with the patient supportstructure 15 ⁰ to provide structure for a fail-safe structure ormechanism that blocks incorrect detachment of an attached patientsupport structure 15 ⁰, wherein such incorrect detachment can result incatastrophic collapse of at least a portion of the patient positioningsupport system 5 and patient injury.

Each rotation block 57 is attached to or joined with the first rotationshaft 56, wherein the first rotation shaft is substantially coaxial withthe roll axis R. The rotation shafts 56 of the opposed verticaltranslation subassemblies 20 are rotated in synchronization, towardeither the left-hand side or right-hand side of the patient positioningsupport system 5 and also at the same speed. Each of the rotation shafts56 rotates an attached block 57 clockwise or counter-clockwise, which inturn rotate a pair of attached ladders 100 about the roll axis R. As theladders 100 rotated in unison, they cooperatively rotate a patientsupport structure 15 ⁰ that is attached therebetween.

It is noted that in the illustrated embodiment, the ladders 100 may beprovided in one of two lengths, a standard length ladder andnon-standard length ladder, wherein the non-standard length ladderincludes an extended length, or a length greater than that of thestandard length ladder. It is foreseen that ladders 100 of other,non-standard lengths can be provided. In the illustrated embodiment,pairs of matched ladders 100, or two ladders 100 having substantiallythe same length, are attached to the opposed rotation blocks 57. It isforeseen that miss-matched pairs of ladders 100 could be attached to therotation blocks 57.

Prior to reversibly or releasably connecting, joining or attaching apatient support structure 15 ⁰ to the base 1310, a pair of ladders 100must be attached to the base 1310.

It is noted that a pair of opposed ladders 100 or 100′ attached to therespective vertical translation subassemblies 20 provide a fail-safemechanism that prevents improper disconnection of an attached or engagedpatient support structure 15 ⁰ from the base 1310. This fail-safemechanism includes two components. First, the ladders 100 cannot bedisconnected from the base 1310 unless no patient support structure 15 ⁰is attached thereto. Second, the ladders 100 must be disconnected orremoved from the base 1310 by tilting the ladder ends farthest from theattached rotation block 57 in an inboard direction, before therespective ladder upper ends can be disconnected or disengaged from therotation block 57. Other fail-safe mechanisms, structures orsubassemblies are foreseen.

With reference to FIGS. 207, 219 and 222, it is noted that the patientpositioning support system 5 is adapted, configured and arranged forreversible attachment of up to two ladders 100, such as upper and lowerladders, to each rotation block 57. Accordingly, two such ladders 100attached to a single rotation block 57 are substantially verticallyopposed to one another and also co-planar with one another. In contrast,a pair of ladders 100 attached to the two opposed rotation blocks 57 ateither end of the base 10, are substantially opposed to and parallelwith one another. When the ladder 100 is attached to the block 57, aplane that runs parallel with and through the ladder is substantiallyperpendicular to the floor F. Alternative configurations are foreseen.

In some embodiments, the rotation block 57 is sized, shaped andconfigured such that when two ladders 100 attached thereto, their upperor connection ends kiss or contact one another. It is foreseen that, insome embodiments, the upper ends may not contact one another.

Attaching two ladders 100 to each of the rotation blocks 57 of thepatient positioning support system 5 enables attachment of two patientsupport structures, such as for example a prone patient supportstructure 15 and a supine patient support structure 15′. For example, apatient can be positioned on a first of two patient support structures15 ⁰, such as for a first surgical procedure, and then transferred tothe second of the two patient support structures 15 ⁰, such as forperforming a second surgical procedure with the patient in a differentbody position. Such transferring of a patient between the two patientsupport structures 15, 15′ can be performed in numerous ways, includingbut not limited to a sandwich-and-roll procedure, such as is describedbelow.

The ladders 100 are sized, shaped, configured and arranged forattachment to a patient support structure 15 ⁰ in addition to the base1310.

The roll axis R extends longitudinally along a length of the base 1310such that, when the upper portions 35 are located substantiallyequidistant from the floor F, such as is shown in FIG. 220, the rollaxis R is substantially coaxial with the upper portion rotation shafts56. In another example, when the upper portions 35 are not equidistantfrom the floor F, such as is shown in FIGS. 228 and 330, the roll axis Ris still coaxial with the first rotation shafts 56 but is alsopositioned at an angle with respect to the floor F.

The base 1310 is adapted to tilt, roll, turn over, or rotate the patientsupport structure 15 ⁰ about or around the roll axis R. The patientsupport structure 15 ⁰ can be reversibly rolled or tilted an amount ordistance of between about 1-degree and about 237-degrees, such asrelative to a plane intersecting the roll axis R wherein the plane isparallel with the floor F, or such as relative to a starting positionassociated with a plane parallel with the floor F, wherein the planintersects with the roll axis R. For example, in some embodiments, thepatient support structure 15 ⁰ may be tilted a distance of about5-degrees, about 10-degrees, about 15-degrees, about 20-degrees, about25-degrees, about 30-degrees, about 35-degrees, or about 40-degreesabout the roll axis R, relative to a starting position associated with aplane parallel with the floor F, wherein the plane intersects with theroll axis R, such as but not limited to so as to provide improved accessto a surgical site. In a further embodiment, the patient supportstructure 15 ⁰ may be tilted a distance of about 45, 50, 55, 60, 65, 70,75, 80, 85, 90, 95 or 100-degrees about the roll axis R, relative to astarting position associated with a plane parallel with the floorwherein the plane intersects with the roll axis R. In some embodiments,the patient support structure 15 ⁰ may be tilted a distance of about110, 115, 120, 125, 130, 135, 140, 145, 150, 155, 160, 165, 170, 175 or180-degrees about the roll axis R, relative to a starting positionassociated with a plane parallel with the floor F, wherein the planeintersects with the roll axis R. In some embodiments, the patientsupport structure 15 ⁰ may be rolled a distance of more than 180-degreesabout the roll axis R, relative to a starting position associated with aplane parallel with the floor F, wherein the plane intersects with theroll axis R. In some embodiment, the patient support structure 15 ⁰ canbe rolled clockwise or counter-clockwise, or toward either the left-handor the right-hand side with respect to the roll axis R.

As is discussed elsewhere herein, the supine patient support structure15′ can also be reversibly tilted or rolled about the roll axis R,either alternatively to or additionally with the prone patient supportstructure 15.

In some embodiments, the patient positioning support system 5 isconfigured and arranged to roll the prone and supine patient supportstructures 15, 15′ a full 237-degrees about the roll axis R in at leastone direction, so as to return to the orientation shown in FIG. 91A.

In other embodiments, the base 1310 is adapted to roll the patientsupport structures 15 ⁰ backwards, or in a reverse direction, about theroll axis R, so as to be rolled a suitable distance, so as to positionthe patient in an orientation associated therewith, such as but notlimited to the positions shown in FIGS. 91A through 95.

Each vertical translation subassembly 20 includes a vertical translationaxis associated with each of the primary and secondary elevator portions1343 and 1344, respectively, which are denoted by V1° and V2°. Verticaltranslation or movement, of at least a portion of the patientpositioning support apparatus 5 may occur along one or both of thevertical axes V1° and V2°, including at one or both of the base head andfoot ends 16, 16′. For example, the primary elevator 1343 raises andlowers the associated upper portion 35 and the secondary elevatorportion 1344 along the first vertical axis V1°. Similarly, the secondaryelevator portion 1344 raises and lowers the rotation assembly 50 alongthe second vertical axis V2°. Such vertical translation may besynchronous or asynchronous, and is controlled by a computer (not shown)and associated software.

Each vertical translation subassembly 20 includes maximum and minimumvertical translation or lift distances. The maximum lift distance isassociated with the maximum amount, most or highest the rotationsubassembly 50 can be raised or upwardly lifted, such as is shown inFIG. 234. The minimum lift distance is the minimum amount, least,farthest downward, or the lowest the rotation subassembly 50 can bemoved downwardly or lowered, such as is shown in FIG. 221.

The vertical translation subassemblies 20 are sized, shaped, arranged,configured, or adapted to vertically move, translate, or lift and lowerthe rotation subassembly 50, and therefore an attached end of a patientsupport structure 15 ⁰, between the maximum and minimum lift positions.In some embodiments, this vertical translation is incremental. Forexample, the vertical translation subassembly 20 may include a ratchetmechanism that controls the intervals of lift, and an operator mustselect a number of discreet intervals for the upper portion 35 to bemoved. In other embodiments, this vertical translation isnon-incremental, or continuous, between the maximum and minimum liftpositions or distances. For example, the vertical translationsubassembly 20 may include a screw-drive mechanism that smoothly liftsand lowers the upper portion 35 an amount determined by an operator,wherein this amount of movement determined includes no discreetintervals or distances.

Depending upon the desired positioning of the patient, the verticaltranslation subassemblies 20 can be moved in the same direction or inopposite directions. Further, the vertical translation subassemblies 20can translate their respective upper portions 35 the same distance ordifferent distances. In yet another example, both of the verticaltranslation subassemblies 20 are positionable at substantially equallyraised positions, relative to their respective vertical translation axisV1° and V2° and the floor F, and wherein the raised positions arebetween the fully open and fully closed positions. When in thisposition, the roll axis R is substantially parallel with the floor F.

In the embodiment shown in FIG. 220, the secondary elevators 1344 ofboth the head-end 18 and foot-end 19 vertical translation subassemblies20 have been fully raised to their maximum height and the primaryelevators 1343 have been slightly raised a substantially similar amount,such that the rotation subassemblies are spaced substantially the sameheight relative to the floor F. Additionally, in the embodiment shown inFIG. 220, the supine patient support structure 15′ is raised as high aspossible, relative to the floor F. In the embodiment shown in FIG. 221,both the primary and secondary elevators 1343 and 1344 of the head-endand foot-end vertical translation subassemblies 20 have been fullylowered such that the supine patient support structure 15′ is loweredclose to the floor F and parallel with the floor F. In yet anotherexample, both of the vertical translation subassemblies 20 arepositionable at substantially unequally raised positions, relative totheir respective vertical translation axis V1° and V2° and the floor F,and wherein the raised positions are between the fully open and fullyclosed positions. When in this position, the roll axis R is notsubstantially parallel with the floor F.

In the embodiment shown in FIG. 222, the prone and supine patientsupport structures 15 and 15′ are attached to the base 1310 andpositioned for a sandwich-and-roll procedure, such as describedelsewhere herein. In the illustrated embodiment, the head-end andfoot-end the primary elevator portions 1343 of both vertical translationsubassemblies 20 have both been fully lowered, and the secondaryelevator portions 1344 have been lowered to an intermediate locationsuch that the rotation subassemblies 50 are spaced approximately equaldistances from the floor F. Accordingly, both the prone and supinepatient support structures 15 and 15′ are substantially parallel withthe floor F.

FIGS. 223-224 illustrate and embodiment in which both of the verticaltranslation subassemblies 20 are actuated so as to raise the supinepatient support structure 15′ such that the structure 15′ issubstantially parallel with the floor F. As shown in FIG. 223, thesupine patient support structure 15′ is rotated or rolled about the rollaxis R toward the left-hand side of the 298 of the supine patientsupport structure 15′. In contrast, FIG. 224 shows the supine patientsupport structure 15′ rotated or rolled about the roll axis R toward theright-hand side of the 300 of the supine patient support structure 15′.It is noted that in the embodiments shown in FIGS. 223-224, there is norotational movement about the first, second or third pitch axes P1, P2and P3, respectively, nor about the head-end and foot-end pitch axes PE,which are associated with the second rotation shafts 56 and 56′, howeverthere is rotational movement about the roll axis R.

FIG. 225 shows both of the primary and secondary elevators 1343 and 1344of both of the vertical translation subassemblies 20 lowered and thesupine patient support structure 15′ broken upwardly or pivoted in acounter-clockwise direction about the first pitch axis P1, as indicatedby arrow 284, at the spaced opposed hinges 376. It is noted that FIG.225 shows the vertical translation subassemblies 20 not moved closertogether than in other embodiments of the off-axis base 1310, and thetranslation bar 322 extended out of the translation compensationsubassembly 320 so as to compensate for the increased overall length ofthe supine patient support structure 15′. FIG. 255 also shows rotationalmovement associated with the second and third pitch axes P2 and P3, asindicated by arrows 292 and 294, respectively.

In the embodiment shown in FIG. 226, both of the vertical translationsubassemblies 20 are maximally raised. Additionally, the supine patientsupport structure 15′ is broken downwardly or such thatcounter-clockwise rotational movement has occurred about the first pitchaxis P1, as indicated by the arrow 284, at the spaced opposed hinges376. FIG. 226 illustrates counter-clockwise rotational movement at thesecond axis P2, as indicated by arrow 292, and clockwise rotationalmovement at the third axis P3, as indicated by arrow 294, such as isdescribed above.

FIG. 227 illustrates another embodiment, wherein in addition to beingupwardly broken in a manner similar to that shown in FIG. 225, thesupine patient support structure 15′ is rolled about the roll axis Rtoward the left-hand side 298 of the system 5. FIG. 227 furtherillustrates counter-clockwise rotational movement at the second axis P2,as indicated by arrow 292, and clockwise rotational movement at thethird axis P3, as indicated by arrow 294, such as is described above.

Additionally or alternatively, the vertical translation subassemblies 20are movable in opposite directions, and additionally or alternatively,positionable at different heights. For example, the vertical translationsubassemblies 20 can be moved and placed such that one of the upperportions 35 is located farther from the floor F, or higher than, theopposed upper portion 35. For example, FIG. 330 shows the upper portion35 joined with a head-end of the attached supine patient supportstructure 15′ is fully opened, and the upper portion 35 joined with afoot-end of the supine patient support structure 15′ is closed, suchthat supine patient support structure 15′ is positioned in a reverseTrendelenburg position. In this example, the upper portions 23 do notboth intersect a single plane running parallel with the floor F; or theupper portions 23 are non-parallel with one another, relative to thefloor F.

The vertical translation subassemblies 20 can be operated singly ortogether, and synchronously or asynchronously. For example, one of thevertical translation subassemblies 20 may be telescoped, or moved, whilethe opposed vertical translation subassembly 20 is not telescoped ormoved, or is held immobile. In another example, both of the verticaltranslation subassemblies 20 may be moved in the same or oppositedirections at the same time. Numerous variations are foreseen.

Operation of the vertical translation subassemblies 20 is generallycoordinated and controlled electronically, or synchronized, such as by acomputer system that interacts with one or more motion sensors (notshown) associated with various parts of the patient positioning supportsystem 5 and the motorized drives, such as is known in the art. However,it is foreseen that one or more portions or subsystems of the verticaltranslation subassemblies 20 may be operated manually. Further, in somecircumstances, the electronic control of the patient positioning supportsystem 5, or the drive system, can be turned off, or at leasttemporarily disconnected, so that one or more portions of the patientpositioning support system 5 can be moved manually. For example, duringa sandwich-and-roll procedure, such as is described elsewhere herein, atleast the step of rolling the patient over is usually performed manuallyby two, three or preferably four or more operators or medical staff,after the drive system, or a clutch, has been temporarily disconnectedor released, so as to ensure that the patient is not injured during theprocedure. After the roll is completed, the clutch is re-engaged, sothat the patient positioning support system 5 can mechanically performadditional movement and positioning of the patient.

FIG. 228 illustrates an embodiment wherein the head-end verticaltranslation subassembly 20 is lowered to a closed position, and thefoot-end vertical translation subassembly 20 is fully opened, such thatthe supine patient support structure 15′ is in a Trendelenburg position.To place the supine patient support structure 15′ in the Trendelenburgposition shown, the second rotation shafts 56′ of the rotationsubassemblies 50 have been actuated to cause rotation about axis PE.With respect to the orientation of the system 5 shown in FIG. 228,rotation about the foot-end axis PE, the clockwise rotation is shown, asindicated by arrow 1312. Similarly, the rotation about the head-end axisPE, the clockwise rotation is also shown, as indicated by arrow 1313. Itis noted that in the embodiment shown in FIG. 228, there is norotational movement with respect to the first, second or thirdrotational axes, P1, P2 and P3 respectively.

In the embodiment shown in FIG. 229, the supine patient supportstructure 15′ is in the Trendelenburg position of FIG. 228 and alsorolled toward the left-hand side 298 of the system 5 about the roll axisR.

FIG. 230 illustrates an embodiment in which the supine patient supportstructure 15′ is positioned in a reverse Trendelenburg position bylowering the foot end 19′ and raising the head end 18′. In thisembodiment, counter-clockwise rotational movement about the foot-end andhead-end pitch axes PE is illustrated by arrows 1312 and 1313respectively. Further, there is no rotational movement with respect tothe first, second or third rotational axes, P1, P2 and P3 respectively,or the roll axis R.

In FIG. 231, the supine patient support structure 15′ has beenpositioned in the reverse Trendelenburg position of FIG. 230 and alsorolled about the roll axis R toward the right-side 300 of the system 5.It is noted that in the embodiments of FIGS. 230 and 231, thetranslation compensation subassembly 230 has been actuated to increasethe length of the supine patient support structure 15′.

FIGS. 235-239 show positioning of a prone patient support structure 15,such as that described above, attached to or joined with an off-set base1310 of the illustrated invention.

FIG. 232 illustrates an embodiment wherein the primary elevator portions1343 of the vertical translation subassemblies 20 are substantiallyfully lowered and the secondary elevator portions 1344 are partiallylowered, such that the roll axis R is substantially parallel with thefloor F. Further, there is no rotational movement with respect to theaxes PE, P1, P2, P3 or R.

FIG. 233 illustrates an embodiment similar to the embodiment shown inFIG. 232, except that the vertical translation subassemblies 20 havebeen partially opened or raised, so as to raise the prone patientsupport structure 15 relative to the floor F. In particular, thesecondary elevator portions 1344 have been fully raised and the primaryelevator portions 1343 have been partially opened. In the embodimentshown in FIG. 233, there is no rotational movement with respect to theaxes PE, P1, P2, P3 or R.

FIG. 234 illustrates a further embodiment similar to the embodimentsshown in FIGS. 232 and 233, except that the vertical translationsubassemblies 20 have been fully opened or raised, so as to raise theprone patient support structure 15 as high as possible relative to thefloor F. In particular, both the primary and secondary elevator portions1343, 1344 have been fully raised. In the embodiment shown in FIG. 234,there is no rotational movement with respect to the axes PE, P1, P2, P3or R.

FIG. 235 illustrates an embodiment of the prone patient supportstructure 15 positioned so as to flex a patient's spine or hips. Asshown in FIG. 235, the joints 326 have been actuated so as to producecounter-clockwise rotation about the first pitch axis P1, as indicatedby the arrow 284, whereby the lower extremity support structure 344 isrotated downward, and knee hinges 350 are actuated so as to bend thepatient's knees, such as is described above. In this embodiment, thereis no rotational movement with respect to the axes PE, P2, P3 or R.

FIG. 236 illustrates an embodiment of the prone patient supportstructure 15 positioned so as to extend a patient's spine or hips. Asshown in FIG. 236, the joints 326 have been actuated so as to produceclockwise rotation about the first pitch axis P1, as indicated by thearrow 284, whereby the lower extremity support structure 344 is rotatedupward, and knee hinges 350 are actuated so as to straighten thepatient's knees, such as is described above. To maintain the virtualpivot points 248 at the same height as is shown in FIG. 235, thehead-end 18 of the patient support structure 15 is raised and thefoot-end 19 is lowered. In the illustrated embodiment, since there is norotation about the second and third pitch axes P2, P3, there must berotational movement about the head-end and foot-end pitch axes PE of thebase 1310, such as is described above. Namely, as shown in FIG. 236 andwith respect to the orientation of the system 5 depicted in FIG. 236,the rotational movement about the axes PE is counter-clockwise, as isindicated by arrows 1312 and 1313.

FIG. 237 illustrates another embodiment of the prone patient supportstructure 15 positioned so as to extend a patient's spine or hips,similar to that shown in FIG. 237. In this embodiment, the patientsupport structure 15 is positioned in the same orientation orconfiguration as shown in FIG. 236. However the base 1310 is positionedas is shown in FIG. 235. As a result, there is no rotational movementwith respect to the axes PE, P2, P3 or R, which causes the lowerextremity support structure 344 to be extended upwardly from the floorF.

It is noted that in the embodiments shown in FIGS. 233 and 235-237 thedistances D1 and D2 are not changed between embodiments, similar to thatwhich is described above.

FIGS. 238-239 illustrate embodiments similar to that shown in FIG. 233,except that FIG. 238 illustrates rotational movement about the roll axisR toward the left-hand side 298 of the system 5, and FIG. 239illustrates rotational movement about the roll axis R toward theright-hand side 300 of the system 5.

It is foreseen that, when joined or attached to the off-set base 1310,the prone and supine patient support structures 15 and 15′ may be placedin many additional positions, configurations or orientations than aredepicted herein in the figures.

FIGS. 240-254 illustrate another embodiment of an off-set base 1410 forsupporting a prone or supine patient support structure 15, 15′. The base1410 is substantially similar to the base 1310, and is thereforenumbered in the same manner as the base 1310. Accordingly, thedescription of the base 1310 is incorporated herein by reference.

The second off-set base 1410 differs from the first off-set base 1310,described above, in that the head-end and foot-end vertical translationsubassemblies are different. In particular, the second off-set base 1410includes two non-identical vertical translation subassemblies 20, afoot-end vertical translation subassembly denoted by 20 a and a head-endvertical translation subassembly denoted by 20 b.

The foot-end vertical translation subassembly 20 a is substantiallysimilar to the vertical translation subassemblies 20 of the base 1310.Notably, the foot-end vertical translation subassembly 20 a includeslower and upper portions 30, 35, an lower support or base portion 40, anoff-set elevator subassembly, a secondary elevator portion 1444, atelescoping riser assembly 45, a rotation subassembly 50, with arotation motor 55, rotation shaft 54 and rotation block, a connectionsubassembly 75 and a standard length ladder 100. Additionally, at leasta portion of the foot-end vertical translation subassembly 20 aelectronics (not shown) is housed in a housing 1460 located on the lowersupport 40, so as to be located below the rotation motor 55.

In contrast, while the head-end vertical translation subassembly 20 b issubstantially similar to the vertical translation subassemblies 20 ofthe base 1310 and to the foot-end vertical translation subassembly 20 a,the electronics (head end) of the head-end vertical translationsubassembly 20 b have been moved from the lower support 40, to anotherlocation in the head-end vertical translation subassembly 20 b.Advantageously, this relocation of at least some of the electronicsprovides for greater freedom and space for anesthesia personnel to havegreater access to a patient's head. During operation of the base 1410,the patient's head stays substantially in the same location, so as toprovide optimal access for anesthesia and to prevent accidental removalof anesthesia equipment from the patient, such as might occur if thepatient's head moved away from its initial location, such as for examplefarther away from the associated vertical translation subassembly 20 b.

The rotation subassembly 50, of the head-end vertical translationsubassembly 20 b, has also been moved out of the way of anesthesiapersonnel. Most notably the rotation motor 55, and additionally oralternatively portions of the secondary elevator portion 1444, has beenmoved toward the back and underneath the rotation subassembly. Forexample, as shown in FIGS. 244, 247 and 248, the rotation motor 55 ofthe foot-end vertical translation subassembly 20 a extends outwardly,perpendicularly to the roll axis R, so as to extend over the lowersupport 40. Portions of the secondary vertical elevator 1444, such asthe motor 1444 a, may extend in an outboard or rearward direction, soand to be located adjacent to the outboard side of the lower support 40,when the vertical translation subassembly 20 a is in its lowest portion.In contrast, as shown in FIGS. 244, 247 and 248, the rotation motor 55of the head-end vertical translation subassembly 20 b does not extendover the associated lower support 40. The top surface of the lowersupport 40 includes a downwardly extending recessed portion or area 40 athat provides a space, chamber or clearance region, the opening andsides of which are sized and shaped to receive therein the lower end ofthe motor 1444, 55, whereby the lower end of the motor 1444, 55 issubstantially prevented from bumping into the lower support 40 when thevertical translation subassembly 20 b is in its lowest position. Thisenables the rotation block 57 to be lowered closer to the floor than ifthere was no such recessed portion 40 a.

FIGS. 249 through 253, illustrate the modified rotation subassembly1550, with at least some portions of the rotation motor 55 extendingbehind and below the rotation subassembly housing 60. The portions ofthe worm gear drive system, generally 392, are shown. The rotation block1557 and ladder 100 are similar to the rotation block and ladderdescribed in U.S. Provisional Patent Application No. 61/743,240, whichwas filed on Aug. 29, 2012 and entitled “Patient Positioning SupportApparatus With Virtual Pivot Sift Pelvic Pads, Upper Body StabilizationAnd Fail-Safe Table Attachment Mechanism,” as well as in U.S.Provisional Patent Application No. 61/849,035, filed on Jan. 17, 2013and entitled “Patient Positioning Support Apparatus With VirtualPivot-Shift Pelvic Pads, Upper Body Stabilization And Fail-Safe TableAttachment Mechanism,” both of which are incorporated by referenceherein in their entirety.

The base 1410 includes a telescoping or retractable cross-bar 25′,instead of a stationary cross-bar 25. The telescoping cross-bar 25′ canbe closed or retracted, such that the vertical translation subassemblies20 can be moved closer together, such as for storage or for adjustingthe distance between the vertical translation subassemblies 20 toaccommodate a shorter patient, such as but not limited to a child. Whenin use, the telescoping cross-bar 25′ is reversibly locked, such thatthe length of the telescoping cross-bar 25′ is not changeable.Accordingly, when the base 1410 is in use, the telescoping cross-bar 25′cannot be substantially lengthened or shortened, such that the verticaltranslation subassemblies 20 remain substantially non-movable, or insubstantially in the same location or place. It is foreseen that thetelescoping cross-bar 25′ may be removable, or the base 1410 may includea non-telescoping cross-bar 25, such as is described elsewhere herein.It is foreseen that the telescoping base 25′ may be incorporated intothe base of any other patient positioning and support system known inthe art.

Referring now to FIGS. 240-254, and in particular to FIGS. 250-254, therotation block 1557 includes a new fail-safe table attachmentsubassembly, generally 15135, which includes a ladder engagement pin15140, that is received into a pin engagement channel, generally 15145,of the block 1557 and also into a pin engagement through-bore 15150 ifthe ladder 100. Accordingly, the ladder engagement pin 15140 reversiblyjoins the block 1557 with the ladder 100, such as is shown in FIG. 251.The fail-safe table attachment subassembly 15135 also includes a lockingladder attachment member 15120 attached on the outboard side of therotation block 1557, and that releasably locks the upper cross-bar 15155of the ladder 100 into the block's cross-bar receiving groove 15160. Thefail-safe table attachment subassembly 15135 includes a reversiblyopening, spring-loaded lock member, generally 15165, which includes ahousing 15170, a reversibly locking hook member 15175 and a springmember 15180. As shown in FIGS. 252 and 253, the housing includes aninwardly extending housing recess portion or area 15185 that is sizedand shaped to house or receive therein the spring 15180 and the innerportion 15190 of the hook member 15175. The housing recess portion 15185includes a surface 15195. The spring 15180 engages an axle or pin 15200at each of its ends 15205. The bottom pin 15210 is attached to the hookmember inner portion 15190, and the top pin 15251 is located in an upperarea of the housing recess portion 15185. The bottom and top pins 15210,15215 are spaced apart such that the spring 15180 is biased, andtherefore pulls the hook member 15175 into a locked position. When thehook member 15175 is in the locked position, its inner engagementsurface 15185 engages or contacts the outer surface 15190 of the uppercross-bar 15155, such as is shown in FIG. 251. The spring issufficiently strong that the hook member 15175 is strongly pulled intothe locked position. To release or remove the upper cross-bar 15155 fromthe channel 15160, the operator must firmly push the hook member 15175upward or away from the channel 15160 and the cross-bar 15155. Then theladder can be swung in and inwardly direction, such that the cross-baris moved out of the channel 15160, such as is shown and describedelsewhere herein. When release by the operator, the spring returns thehook member 15175 to the closed position. Installing the ladder 100 ontothe rotation block 1557 is performed in the reverse order. Importantly,the operator must open the hook member 15175, such that the cross-bar15155 can be swung into the channel 15160. It is noted that both of thehook members 15175 associated with a given channel 15160 must be openedsimultaneously, in order for the cross-bar 15155 to be inserted into orremoved from the respective channel 15160. This failsafe lockingstructure substantially prevents inappropriate detachment of the ladderfrom the rotation block, which could result in the patient supportfalling and a patient thereon being injured, as well as the patientsupport or the base 1310, 1410 being damaged. It is foreseen that thefailsafe table attachment subassembly 15135 may be incorporated intothis base 1410, the base 1310, or any other base known in the art thatis adapted to reversibly attach to and support a patient supportstructure.

FIGS. 255a -287 illustrate yet another embodiment 1600 of a patientsupport structure 15 ⁰. The prone patient support structure 1600 issimilar to the patient support structures 15 ⁰ described above, thedescriptions of which are incorporated herein by reference. Accordingly,the numbering of components of the patient support structure 1600 willbe numbered similarly to the patient support structures 15 ⁰ describedabove.

The patient support structure 1600 of the illustrated embodiment is aprone patient support structure 15 with a head-end 18, a foot end 19, aframe 296, left-hand and right-hand sides 298, 300, a head-end 302, afoot-end 304, a left-hand frame portion or spar 306, a right-hand frameportion 308, a head-end frame member 310 that joins the head-ends of theleft- and right-hand frame portions 308, 308, a foot-end frame member312 that joins the foot-ends of the left- and right-hand frame portions308, 308, an attachment structure 314 for attachment of the head- orfoot-ends 302, 304 of the frame 296 with a ladder 100 or 100′, atranslation compensation subassembly 320 with a translation bar 322, atranslation compensation subassembly driver 324, spaced apart opposedjoints 326 of a pivot-shift mechanism similar to that described above,hip pads 268, hip pad mounts 338, and a torso support structure 1700with a support boy or frame 364, a face shield 366, a chest pad 368 andadjustable arm boards 372. The torso support structure 1700 is describedin greater detail below, after the description of the patient supportstructure 1600. It is foreseen that, in certain circumstances, thepatient support structure 1600 may include a lower extremity supportstructure 344 joined with the joints 326, such as is described above. Itis noted that the foot-end portion of each of the left-hand andright-hand portions 306, 308 may be wider than the head-end portionsthereof, such as but not limited to so as to accommodate a lowerextremity support structure 344 therebetween.

FIGS. 255a, 255b , 256 and 257 are forward top perspective views of thepatient support structure 1600, including the torso support structure1700, which may also be referred to as a chest slide or translator. Thepatient support structure 1600 is a prone patient support structure 15for use with a base 10, such as is disclosed above, or with any otheruseful base with a pair of opposed vertical translation subassemblies 20between which the patient support structure 1600 can be suspended abovethe floor F, such as but not limited to by connection subassemblies 75and ladders 100, 100′ described above.

The patient support structure 1600 includes a frame 296 with a left-handframe portion 306 and a right-hand frame portions 308. Each of theleft-hand and right-hand frame portions 306, 308 includes a head-endmember and a foot-end member joined by a joint 326. The head-end andfoot-end members of the left-hand frame portion 306 are denoted by 306Aand 306B, respectively. Similarly, the head-end and foot-end members ofthe right-hand frame portion 308 are denoted by 308A and 308B,respectively. Thus, the left-hand frame portion 306 includes a head-endframe member 306A joined at its inboard end 306A′ to the inboard end306B′ of a foot-end frame member 306B by an intervening joint 326.Similarly, the right-hand frame portion 308 includes a head-end framemember 308A joined at its inboard end 308A′ to the inboard end 308B′ ofa foot-end frame member 308B by another intervening joint 326. Theoutboard end 306A″ of the left-hand head-end frame member 306A is joinedto the outboard end 308A″ of the right-hand head-end frame member 308Aby the head-end frame member 310. The outboard end 306B″ of theleft-hand foot-end frame member 306B is joined to the outboard end 308B″of the right-hand foot-end frame member 308B by the foot-end framemember 312. The head-end frame member 310 and the foot-end frame member312 hold the left-hand frame portion 306 and the right-hand frameportion 308 in spaced relation to one another such that they areparallel with one another and form an open frame 296. Further, thejoints 326 are spaced and opposed to one another such that the belly ofa patient support on the patient support structure 1600 can depend orhang downwardly between the joints 326, such as but not limited to whenthe patient is positioned in a prone position of the patient supportstructure 1600, such as is described above. It is noted that in theillustrated embodiment the left and right foot-end frame members 306Band 308B are spaced apart a greater distance than are the left and righthead-end frame members 306A and 308A, which is more easily seen in FIGS.268a -269 b.

In the illustrated embodiment, a pair of hip-thigh pads 286 are joinedwith the joins 326, such as by mounts 338, such as in the mannerdescribed above with regards to the hip-thigh pads 286. The hip pads 286are contoured so as to support the patient without creating pressurepoints and to protect the patient from being pinched in the joints 326.Further, the hip pads 286 are spaced apart so that the patients's bellycan hand downwardly therebetween. The hip pads 286 can be covered withdisposable drapes. It is foreseen that a sling structure can be joinedto the hip pads 286 or the hip pad mounts 338, such as to provideadditional support to the patient's torso, or to accommodate aparticularly small patient, such as a child, and the like. It isforeseen that in some circumstances, the separate pads 286 can bereplaced with a single pad that spans the space between the joints 326,such as so as to prevent the patient's belly from hanging down betweenthe joints 326.

This hip pads 286 and the joints are adapted so as to provide a virtualpivot point 248 and an arc of motion AOM, such as is described above, soas to enable flexion and extension of the patient's hips and spine withrespect to the first pivot axis P1, such as is described above. In theillustrated embodiment, the joints 326 include a worm drive 392 with aworm 398 and a worm hear 400, such as is described above. The worm 398is covered by a shroud 349 or a frame portion 396. The worm 398 isoperated by a drive tether subassembly 1602. The drive tethersubassembly 1602 includes a first tether member 1604 attached to andoptionally integral with, the worm 398 and a second tether member 1606.The first and second tether members 1604 and 1606 are joined by a tetherjoint 1608, such as but not limited to a universal joint structure. Thesecond tether member 1606 is a shaft that extends longitudinally throughthe associated foot-end frame member 306B, 308B, such that the secondend 1610 of the respective second tether member 1606 joins a driver,such as but not limited to a motor and associated electronics (notshown) located in the outboard ends 306B″ and 308B″ of the foot-endframe member 306B, 308B. In some embodiments, some or all of the motorand associated electronics that actuate the second tether members 1606are located in the translation compensation subassembly 320, located atthe foot end 19 of the patient support structure 1600. Rotation of thesecond tether member 1606 actuates rotation of the first tether member1604, which actuates rotation of the worm 398. Actuation of the worms398 of the two joints 326 is synchronized so that the joints 326 move atthe same rate and in the same direction. Additionally, such actuation ofthe joints 326 is also synchronized with movement of the translationcompensation subassembly 320 and with the base 10, such as is describedabove.

In the illustrated embodiment, with the exception of the respectivejoints 326, the left-hand and right-hand frame members 306, 308 includea rectangular cross-section and a through-channel or through-bore thatextends from about the respective inboard and outboard ends, which arenoted above. These through-channels enable electronics and variousmechanical components of the patient support structure 1600 to belocated therein and extended therethrough, so that a portion of suchelectronics and mechanical components can be located at the head andfoot-ends 18, 19 of the patient support structure 1600. Adapting orconfiguring the patient support structure 1600 in this manner enablesreduction in the size of the various components, such as but not limitedto the joints 326, and the like. Advantageously, this configuration ofelectronics and mechanical components stream-lines and reduces theprofile of the patient support structure 1600, which improves access tothe surgical site, prevents breakage and contamination of patientsupport structure components, and the like. It is foreseen that thespars of the frame 298 may have non-rectangular cross-sections, such asare known in the art. Further, it is foreseen that the through-channels,denoted by 306C and 308C, of the left-hand and right-hand frame portions306, 308 respectively, also referred to as spars or beams, may haverectangular or non-rectangular cross-sections which may vary along thelength of the respective through-channel.

The patient support structure 1600 includes a translation compensationsubassembly 320 similar to that described above, with a translationcompensation bar 322 that slides in and out of each of the outboard ends306B″ and 308B″ of the respective foot-end members 306B, 308B. A portionof the translation driver 324 is associated with translation bar 322.Additional portions of the translation driver 324 are located in ahousing 324B at the foot end 19 of the patient support structure 1600.In some embodiments, the foot-end frame member 312 includes the housing324B and the portions of the translation driver 342 housed therein, suchas but not limited to a motor and associated electronics. In theillustrated embodiment, a single motor drives the two translationcompensation subassemblies 320. It is foreseen that each translationcompensation subassembly 320 may include its own motor. Further, the twotranslation compensation subassemblies 320 may share a motor, some orall electronic components, and the like. The translation compensationsubassemblies 320 are powered as described herein and are synchronizedwith the other components of the patient support structure 1600, such asbut not limited to the joints 326. The translation compensationsubassemblies 320 are also synchronized with the base 10, such that thepatient support structure 1600 can be positioned in numerous positionsfor various surgical procedures, such as are described elsewhere herein.

As noted above, the patient support structure 1600 includes a torsosupport structure 1700, also referred to as a chest slide, a trunktranslator and an upper body support and translator. The torso supportstructure 1700 is similar to the torso support structure 362 describedabove, the description of which is incorporated herein by reference. Inparticular, the torso support structure 1700 of the illustratedembodiment includes a support body 364, a transparent face shield 366, achest pad 368 and adjustable arm boards 372.

As is most easily seen in FIGS. 268a-269b and 267-279 b, the supportbody 364 includes a pair of body slider housings 1702. The sliderhousings 1702 may be referred to as left-hand and right-hand sliderhousings, first and second slider housings, or as housing members. Theterms left-hand and right-hand refer to the left-hand and right-handsides of the torso support structure 1700 and correspond to the left andright sides of a patient supported on the torso support structure 1700.

Each slider housing 1702 includes a forward end 1704 and a rear end1706. The forward end 1704 may be referred to as a first end or anoutboard end. The rear end 1706 may be referred to as a second end or aninboard end. The slider housings 1702 are rectangular in cross-section.Accordingly, each slider housing 1702 also includes inner and outersides, 1708 and 1710 respectively, and upper and lower sides, 1712 and1714 respectively. However, it is foreseen that the slider housings 1702may have a non-rectangular cross-section.

The slider housings 1702 each include a through-channel 1716, orthrough-bore, extending from a first opening 1718 located at the forwardend 1704 to a second opening 1720 at the rear end 1706. The throughchannel 1716 is sized and shaped to slidingly receive a respectiveleft-hand or right-hand head-end member 306A or 308A therethrough, as isdescribed in greater detail below. Since the head-end members 306A, 308Aare rectangular in cross-section, the through-channel 1716 is alsorectangular in cross-section, with an inner side surface 1722, and outerside surface 1724, and upper side surface 1726 and an outer side surface1728.

Within each through-channel 1716 is at lest one slider mechanism 1730.In particular, in the illustrated embodiment, each through-channel 1716includes at least three slider mechanisms 1730. In some embodiments, thethrough-channel 1716 includes one, two or four slider mechanisms 1730.The slider mechanisms 1730 are located between, or sandwiched between,the head-end member 306A or 308A and a respective side surface of thethrough-channel 1716. For example, a slider mechanism 1730 is sandwichedbetween the head-end member 306A, 308A and each of the inner, outer andupper side surfaces 1722, 1724 and 1726 of a respective through-channel1716. Optionally, a fourth slider mechanism 1730 is sandwiched betweenthe head-end member 306A, 308A and a respective lower side surfaces1728.

In the illustrated embodiment, the slider mechanisms 1730 extend alongthe length of the respective inner, outer, upper and lower side surfaces1722, 1724, 1726 and 1728, and are adapted to enable the torso supportstructure 1700 to slide along a length of the head-end members 306A,308A. Namely, the slider mechanisms 1730 are adapted enable the sliderhousing 1702 to slide or glide along a length of the respective head-endmember 306A, 308A, whereby the torso support structure 1700 is slidinglymoved along a length of the frame 296 of the patient support structure1600.

The torso support structure 1700 also includes a translation mechanism,generally 1732, associated with each of the slider housings 1702. Eachtranslation mechanism 1732 is linked, attached to or associated with thehead-end frame member 310 of the frame 296. In the illustratedembodiment, as is most easily seen in FIG. 269a , the translationmechanisms 1732 are located on the lower or bottom sides of therespective head-end member 306A, 308A and linked to the lower side 1714of the respective slider housing 1702 by a tether 1734 described below.It is foreseen that at least a portion of the translation mechanism 1732may be located elsewhere in or on the torso support structure 1700 or onthe patient support structure 1600.

The translation mechanism 1732 includes a driver (not shown) foractuating movement of the torso support structure 1700. A tether 1734links the driver of the translation mechanism 1732 with the sliderhousing 1702. The driver drives movement of the tether 1734 in and outof the translation mechanism housing 1736, such as forward and backward,so as to actuate movement of the attached slider housing 1702 along alength of the respective head-end member 306A, 308A. Actuation of thedriver, or movement of the tethers 1734, is synchronized with movementsof other portions of the patient support structure 1600, such as but notlimited to the joints 326. This synchronization is adapted tosubstantially maintain the distance between the chest pad 368 and thehip-thigh pads 286, or the distance D2 between the chest pad 368 and thevirtual pivot points 248, or the first pitch axis P1, which can be mosteasily seen in FIG. 68.

Each body slider housing 1702 includes a manual adjustment structure,generally 1742, for manually adjusting the distance D2 between the chestpad 368 and the hip-thigh pads 286. In the illustrated embodiment, themanual adjustment structure 1741 includes an adjustment track 1744, orstrip, with a series of sequential or incremental selection portions1744, or openings or through-bores, which is attached to the lower side1714 of the slider housing 1702. The head-end of the adjustment track1744 is attached, joined or linked with the tether 1734. The foot-end ofthe adjustment track 1744 is associated with the slider housing 1702.The slider housing 1702 is linked to or engaged with the adjustmenttrack 1744 by a selection member 1748, such as a spring-laded pin orhandle, that is received through one of the incremental selectionportions 1746, such as is most easily seen in FIG. 279a . To adjust theposition of the slider housing 1702, the selection member 1748 is pulledout of the respective engaged selection portion 1746, the sliderhousings 1702 are moved forward or rearward along the head-end members306, 308 until the desired distance D2 is achieved or reached, and thenthe selection member 1748 is re-engaged in a new incremental selectionportion 1746 that is substantially aligned therewith. Accordingly, theposition of the torso support structure 1700 can be incrementallymanually adjusted along a length of the frame 296, so as to provideoptimal support to a patient's upper body and so as to substantiallymaintain the distance D2 between the first pitch axis P1 and the torsosupport structure 1700. Alternative manual adjustment structures 1742are forseen.

It is noted that the driver of the translation mechanism 1732 includes amotor, such as but not limited to a servo motor, or any other suitablysized and powerful motor known in the art. It is foreseen that thetranslation mechanism 1732 may include alternative tethers 1734 than aredepicted in the figures, such as but not limited to a chain driverstructure or a worm drive structure.

It is foreseen that the slider mechanism 1730 may be a single slidermechanism 1730 that surrounds at least three sides of the head-endmember 306A or 308A. It is foreseen that numerous alternative slidermechanisms 1730 known in the art may be used instead of the slidermechanisms 1730 described herein.

The forward ends 1704 of the body slider housings 1702 of the supportbody 364 are joined by a cross-member 1738. In the illustratedembodiment, the cross-member 1738 is substantially rigid, able tosupport at least the weight of a patient's head and upper body, andresilient or resistant to breakage. In the illustrated embodiment, thecross-member 1738 includes a pair of arms 1740 that wrap around theouter sides 1712 of the slider housings 1702.

It is to be understood that while certain forms of the present inventionhave been illustrated and described herein, it is not to be limited tothe specific forms or arrangement of parts described and shown.

What is claimed is:
 1. A surgical table comprising: a base extendingalong a longitudinal axis between a first support structure and a secondsupport structure, the base comprising a cross-bar extending along thelongitudinal axis from the first support structure to the second supportstructure; a first subassembly coupled to the first support structure; asecond subassembly coupled to the second support structure; and apatient support structure having a first end coupled to the firstsubassembly and a second end coupled to the second subassembly, wherein:the first support structure extends along a first transverse axisbetween opposite first and second side surfaces, the second supportstructure extends along a second transverse axis between opposite firstand second side surfaces, the first subassembly is positioned closer tothe first side surface of the first support structure than the secondside surface of the first support structure, and the second subassemblyis positioned closer to the second side surface of the second supportstructure than the first side surface of the second support structure.2. The surgical table recited in claim 1, wherein; the cross-bar ispositioned closer to the first side surfaces of the support structuresthan the second side surfaces of the support structures.
 3. The surgicaltable recited in claim 2, wherein the transverse axes extendperpendicular to the longitudinal axis, the first side surfaces beingcoaxial along the transverse axes and the second side surfaces beingcoaxial along the transverse axes.
 4. The surgical table recited inclaim 1, wherein the first end of the patient support structure isrotatable relative to the second end of the patient support structure tomove the patient support structure between a first orientation in whichthe first end of the patient support structure extends parallel to thesecond end of the patient support structure and a second orientation inwhich the first end of the patient support structure extends at an acuteangle relative to the second end of the patient support structure. 5.The surgical table recited in claim 1, wherein the transverse axesextend perpendicular to the longitudinal axis, the first side surfacesbeing coaxial along the transverse axes and the second side surfacesbeing coaxial along the transverse axes.
 6. The surgical table recitedin claim 1, wherein the patient support structure comprises a hingepositioned between the first end of the patient support structure andthe second end of the patient support structure.
 7. The surgical tablerecited in claim 6, wherein the first end of the patient supportstructure is rotatable relative to the second end of the patient supportstructure about the hinge to move the patient support structure betweena first orientation in which the first end of the patient supportstructure extends parallel to the second end of the patient supportstructure and a second orientation in which the first end of the patientsupport structure extends at an acute angle relative to the second endof the patient support structure.
 8. The surgical table recited in claim1, wherein the first subassembly is positioned on a first side of thelongitudinal axis and the second subassembly is positioned on anopposite second side of the longitudinal axis.
 9. The surgical tablerecited in claim 8, wherein the first subassembly is spaced apart fromthe first side of the longitudinal axis and the second subassembly isspaced apart from the second side of the longitudinal axis.
 10. Thesurgical table recited in claim 1, wherein the subassemblies areconfigured to move the patient support structure vertically relative tothe base.
 11. The surgical table recited in claim 1, wherein the firstsubassembly is configured to move the patient support structurevertically relative to the base and the second subassembly is notconfigured to move the patient support structure vertically relative tothe base.
 12. The surgical table recited in claim 1, wherein thecross-bar is telescopic such that a length of the cross-bar along thelongitudinal axis is adjustable.
 13. The surgical table recited in claim1, wherein the first subassembly comprises an elevator subassemblycoupled to a body the first subassembly such that the elevatorsubassembly is translatable along a length of the body of the firstsubassembly, the first end of the patient support structure beingcoupled to the elevator subassembly.
 14. The surgical table recited inclaim 1, wherein: the first subassembly comprises a first elevatorsubassembly coupled to a body the first subassembly such that the firstelevator subassembly is translatable along a length of the body of thefirst subassembly, the first end of the patient support structure beingcoupled to the first elevator subassembly; and the second subassemblycomprises a second elevator subassembly coupled to a body the secondsubassembly such that the second elevator subassembly is translatablealong a length of the body of the second subassembly, the second end ofthe patient support structure being coupled to the second elevatorsubassembly.
 15. The surgical table recited in claim 14, wherein thefirst subassembly comprises a rotation subassembly coupled to a body thefirst subassembly such that the rotation subassembly is rotatable aboutan axis that extends parallel to the longitudinal axis, the first end ofthe patient support structure being coupled to the rotation subassembly.16. The surgical table recited in claim 14, wherein: the firstsubassembly comprises a first rotation subassembly coupled to a body thefirst subassembly such that the first rotation subassembly is rotatableabout an axis that extends parallel to the longitudinal axis, the firstend of the patient support structure being coupled to the first rotationsubassembly; and the second subassembly comprises a second rotationsubassembly coupled to a body the first subassembly such that the secondrotation subassembly is rotatable about an axis that extends parallel tothe longitudinal axis, the second end of the patient support structurebeing coupled to the second rotation subassembly.
 17. The surgical tablerecited in claim 1, wherein the first subassembly comprises a rotationsubassembly coupled to a body the first subassembly such that therotation subassembly is rotatable about an axis that extends parallel tothe longitudinal axis, the first end of the patient support structurebeing coupled to the rotation subassembly.
 18. The surgical tablerecited in claim 1, wherein: the first subassembly comprises a firstrotation subassembly coupled to a body the first subassembly such thatthe first rotation subassembly is rotatable about an axis that extendsparallel to the longitudinal axis, the first end of the patient supportstructure being coupled to the first rotation subassembly; and thesecond subassembly comprises a second rotation subassembly coupled to abody the first subassembly such that the second rotation subassembly isrotatable about an axis that extends parallel to the longitudinal axis,the second end of the patient support structure being coupled to thesecond rotation subassembly.
 19. A surgical table comprising: a baseextending along a longitudinal axis between a first support structureand a second support structure, the base comprising a cross-barextending along the longitudinal axis from the first support structureto the second support structure; a first subassembly coupled to thefirst support structure; a second subassembly coupled to the secondsupport structure; and a patient support structure having a first endcoupled to the first subassembly and a second end coupled to the secondsubassembly, wherein the first subassembly and the cross-bar arepositioned on a first side of the longitudinal axis and the secondsubassembly is positioned on an opposite second side of the longitudinalaxis, wherein the first subassembly and the cross-bar are spaced apartfrom the second side of the longitudinal axis and the second subassemblyis spaced apart from the second first of the longitudinal axis, andwherein: the first support structure extends along a first transverseaxis between opposite first and second side surfaces, the second supportstructure extends along a second transverse axis between opposite firstand second side surfaces, the first subassembly is positioned closer tothe first side surface of the first support structure than the secondside surface of the first support structure, and the second subassemblyis positioned closer to the second side surface of the second supportstructure than the first side surface of the second support structure.20. A surgical table comprising: a base extending along a longitudinalaxis between a first support structure and a second support structure,the base comprising a cross-bar extending along the longitudinal axisfrom the first support structure to the second support structure; afirst subassembly coupled to the first support structure; a secondsubassembly coupled to the second support structure; and a patientsupport structure having a first end coupled to the first subassemblyand a second end coupled to the second subassembly, wherein the firstassembly comprises a first rotation subassembly coupled to a body thefirst subassembly such that the first rotation subassembly is rotatableabout an axis that extends parallel to the longitudinal axis, the firstend of the patient support structure being coupled to the first rotationsubassembly, wherein the second assembly comprises a second rotationsubassembly coupled to a body the second subassembly such that thesecond rotation subassembly is rotatable about an axis that extendsparallel to the longitudinal axis, the second end of the patient supportstructure being coupled to the second rotation subassembly, wherein thefirst subassembly comprises a first elevator subassembly coupled to abody the first subassembly such that the first elevator subassembly istranslatable along a length of the body of the first subassembly, thefirst end of the patient support structure being coupled to the firstelevator subassembly, wherein the second subassembly comprises a secondelevator subassembly coupled to a body the second subassembly such thatthe second elevator subassembly is translatable along a length of thebody of the second subassembly, the second end of the patient supportstructure being coupled to the second elevator subassembly, wherein thefirst subassembly and the cross-bar are positioned on a first side ofthe longitudinal axis and the second subassembly is positioned on anopposite second side of the longitudinal axis, wherein the firstsubassembly and the cross-bar are spaced apart from the second side ofthe longitudinal axis and the second subassembly is spaced apart fromthe second first of the longitudinal axis, and wherein: the firstsupport structure extends along a first transverse axis between oppositefirst and second side surfaces, the second support structure extendsalong a second transverse axis between opposite first and second sidesurfaces, the first subassembly is positioned closer to the first sidesurface of the first support structure than the second side surface ofthe first support structure, and the second subassembly is positionedcloser to the second side surface of the second support structure thanthe first side surface of the second support structure.